Pre-diabetic seeking advice on ketosis...

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KKA

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At risk of diabetes
Hi all, I've just joined and this is my first post.

I have just finished the 1st 7-week course on the NHS Diabetes Prevention Programme. Since 1 January 2019, I have lost 13.5 kgs, 6 of those during the course in the last 5 weeks, after switching to the low carb-high fat diet (with restricted calories) and 2 over the last 5 days (that's the fastest). I started at 100kg and today I am 86.5kg. My HbA1c at the start was 42 but I don't have any subsequent measures. I have had high cholesterol and been on statins for years.

I am 53, female, mixed race (Indian/Welsh) and 5'4". Previously I spent years on a yo-yo low fat diet, so I thought I might as well try this diet. I've never eaten ready meals and rarely eat processed food, always using whole food and cooking from scratch. I love this diet as I get to eat a variety of delicious food and don't feel hungry all the time. I have been going to the gym doing the NHS Couch to 5k programme, and recently adding in stretches and weights. This diet suits me and I hope that I can continue with it and make it my permanent lifestyle, increasing my portions slightly once I reach my target weight..

So I am worried that I have recently been feeling unwell with what I think must be ketosis. The bad breath started a few weeks ago but has got much worse this week. For 5 days I have felt unwell - weak, tired, brain-fog, and a bad taste in my mouth. I haven't felt strong enough to go to work let alone the gym. On one occasion only, 2 days ago, I had palpitations and felt weak and light-headed. This went after a long lie-down and lots of water. I have looked up the symptoms and I guess that this is ketosis. However I don't know if I am safe and whether this could be keto-acidosis. Last night I drank a lot of water through the night and I don't feel as bad today, but still not right.

My fitbit records for Wednedsay this week are: 1131 cals, Fat 88g, Fibre 14g, Carbs 48.7g, Sodium 1203g, Protein 62g so that's Fat 64%, Carbs 16% and Protein 20%. According to my book (X-pert Health), this is ok.

I haven't bothered calling my GP because it's impossible to get an appointment and only one of the doctors at my GP surgery is any good. I can see lots of info online but it would be helpful to hear from an expert:-

1. Am I safe?
2. Should I increase my carb intake (currently I am not eating any refined carbs, only veg and 2 portions of fruit a day, and occasional beans)?
3. Is it essential to eat starchy food? How can I improve my fiber intake (I hate wholemeal bread, pasta etc)?
4. Will the bad breath go away (this is very problematic as I work closely with clients and it tastes terrible)?
5. Am I risking exacerbating my cholesterol level?
6. Can/should I buy a testing kit for blood sugar and ketones?

Really hoping someone can advise me.
 
Mouthwash is a good thing when in ketosis - but try adding in a salad - perhaps replacing a sugary fruit with tomato and cucumber, or sweet pepper if you like it - they are all, botanically, fruits with the same nutrition, but without so much fructose. You might need a little more carb as you are going to the gym and your weight is dropping - though eating a little more in general might help you feel better. We are so conditioned to believe that weightloss is all about calories, and that weightloss is important in controlling glucose, but for me calories are pretty much irrelevant, as long as I don't drop too low, as after so many low calorie diets my body just decides to hibernate until better times come around.
A blood glucose monitor is a good idea, but testing for ketones is expensive and not really important for a type two.
 
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Dietary ketones and blood ketones are entirely different - the latter can only happen if you do not have sufficient insulin circulating in your body.

I don't believe it's possible to buy a ketone meter, think they're prescription only, but you can buy a blood glucose one.

Other than that, I wouldn't have the slightest idea!
 
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Thanks Drummer & Trophywench - very helpful. I did end up talking to the only good GP in the practice and he reassured me it's ketosis and not keto-acidosis and he's going to see me on Monday. I hope this means that i can stick with this way of eating as it's so much better than a low-fat diet. Thanks again.
 
KKA said:
So I am worried that I have recently been feeling unwell with what I think must be ketosis. The bad breath started a few weeks ago but has got much worse this week. For 5 days I have felt unwell - weak, tired, brain-fog, and a bad taste in my mouth. I haven't felt strong enough to go to work let alone the gym. On one occasion only, 2 days ago, I had palpitations and felt weak and light-headed. This went after a long lie-down and lots of water. I have looked up the symptoms and I guess that this is ketosis. However I don't know if I am safe and whether this could be keto-acidosis. Last night I drank a lot of water through the night and I don't feel as bad today, but still not right.
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Sounds like "Keto Flu", it's not an uncommon phenomenon & should pass once you have become keto adapted... Actually you should feel a lot better than before. Ketosis is a condition where ketone bodies are generated from body fat for energy when there is insufficient carbs to satisfy the bodies energy requirements (hence the rapid weight loss). Diabetic Keto Acidosis (simply put) is a life threatening condition where there is very high blood glucose levels but the body is unable to process it (lack of insulin) so then body will turn to ketones for energy; the combination of high levels of BG & ketones will lead to DKA. As a pre-D you are in no danger of DKA.

Fiber on a LCHF diet is very easy, you can get all the fiber you need from the non-starchy plants, if you are having problems with constipation then add psyllium husk powder

Dietary cholesterol is the least of your worries, most blood cholesterol is manufactured in the body from.... Carbs!!!😱

I would definitely get a BG Meter, if you are worried about ketone levels then there are pee sticks which are a whole lot cheaper (useful while you are developing/learning your new diet).
 
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Thanks Martin that’s helpful and reassuring. Definitely need the psyllium husk. I feel much better tonight so maybe it’s passing now.
 
Hi KKA I recently had an episode of Diabetic ketoacidosis . At the time I didn’t know what was going on .
It started by vomiting Friday and Saturday the last time I had eaten was Thursday that being caesar salad .
Then on Sunday , I couldn’t keep water down . It was then I had a problem breathing and luckily my son was worried enough to phone 999 and shortly I had 4 paramedics around me doing all sorts of things including a ecg , blood pressure bloods and oxygen.
I can’t even remember being in an ambulance .
Wow then doctors and nurses were all around me with needles and drips , I just let them do whatever they needed to . A few hours later I was told I had DKA due to my diabetes ! I had never heard of it and the doctor told me I was in a bad way but stable for now and if my son had not rung 999 when he did it could have gone a horrible way with my life in danger !!! I was so shocked !!!
DKA is so very serious and if you feel like something is wrong or find yourself in a similar situation like myself please don’t hesitate to call for an ambulance .
 
Welshchick it sounds like you had a terrible time. Sorry to hear. I'm still have ketosis symptoms but not as badly as before. I'm hoping the brain fog and bad breath will start to improve. I did check in with my GP and he reassured me. I hope you don't have this again.
 
Yes it wasn’t pleasant but thank god everybody looked after me .
Good your doctor is aware and helping to reassure you .
I hope things improve quickly for you . 🙂 . I have swollen feet now ! I can’t keep slippers on . Going to be very strict with my food intake and hopefully that will go !!’ 🙄
 
I had a lot of the symptoms you describe when I started Keto. The heart palpitations were a bit scary. I also had a banging headache and was visiting the lavvy nonstop due to the water consumption....apparently it can all be due to an electrolyte imbalance. I felt so much better after I added a tiny bit of good salt to my water and I also drank stock cubes.
Well done on your weight loss - you’re doing great. 🙂
 
Philomena said:
I felt so much better after I added a tiny bit of good salt to my water and I also drank stock cubes
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Forgot about that bit of advice.... Good one!
 
Still have brain fog and bad breath. My cognitive function is definitely impaired and I find it very frustrating as I am aware of my inability to remember and process information as well as I could before ketosis. Extra salt did help but I'm quite salty anyway. Thinking of trying electrolyte supplements.
 
KKA , yes I have to agree with you on this , so much so I am off to the opticians tomorrow having asked my doctor to refer me back to the eye clinic but she said no saying she wasn’t prepared to do that as the opticians can look and test what needs to be done and then they can give me that referral .
I must say I was a bit taken a back by that but thinking on it that’s the logical
Way to go forward as definite changes are occurring and I am sure that referral will be on the cards .
The frustration of trying to remember things and then the brain fog in trying to think of the words I want to say are there and even writing this I have had to stay stay focused , have stopped quite often to go back over it then change it , not to get distracted gosh I feel I am doing an exam !!!!! Lol
 
Hi KKA
well went to the opticians and apart from needing a stronger reading lens and my cataract in each eye still on the small side , nothing sinister going on so I was well happy . 🙂
 
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