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Correction Of Metabolic Acidosis

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What is BASAL METABOLIC RATE? What does BASAL METABOLIC RATE mean? BASAL METABOLIC RATE meaning - BASAL METABOLIC RATE definition - BASAL METABOLIC RATE explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/... license. Basal metabolic rate (BMR) is the minimal rate of energy expenditure per unit time by endothermic animals at rest. It is reported in energy units per unit time ranging from watt (joule/second) to ml O2/min or joule per hour per kg body mass J/(hkg)). Proper measurement requires a strict set of criteria be met. These criteria include being in a physically and psychologically undisturbed state, in a thermally neutral environment, while in the post-absorptive state (i.e., not actively digesting food). In bradymetabolic animals, such as fish and reptiles, the equivalent term standard metabolic rate (SMR) is used. It follows the same criteria as BMR, but requires the documentation of the temperature at which the metabolic rate was measured. This makes BMR a variant of standard metabolic rate measurement that excludes the temperature data, a practice that has led to problems in defining "standard" rates of metabolism for many mammals. Metabolism comprises the processes that the body needs to function. Basal metabolic rate is the amount of energy expressed in calories that a person needs to keep the body functioning at rest. Some of those processes are breathing, blood circulation, controlling body temperature, cell growth, brain and nerve function, and contraction of muscles. Basal metabolic rate (BMR) affects the rate that a person burns calories and ultimately whether that individual maintains, gains, or loses weight. The basal metabolic rate accounts for about 60 to 75% of the daily calorie expenditure by individuals. It is influenced by several factors. BMR typically declines by 12% per decade after age 20, mostly due to loss of fat-free mass, although the variability between individuals is high. The body's generation of heat is known as thermogenesis and it can be measured to determine the amount of energy expended. BMR generally decreases with age and with the decrease in lean body mass (as may happen with aging). Increasing muscle mass has the effect of increasing BMR. Aerobic (resistance) fitness level, a product of cardiovascular exercise, while previously thought to have effect on BMR, has been shown in the 1990s not to correlate with BMR when adjusted for fat-free body mass. But anaerobic exercise does increase resting energy consumption (see "aerobic vs. anaerobic exercise"). Illness, previously consumed food and beverages, environmental temperature, and stress levels can affect one's overall energy expenditure as well as one's BMR. BMR is measured under very restrictive circumstances when a person is awake. An accurate BMR measurement requires that the person's sympathetic nervous system not be stimulated, a condition which requires complete rest. A more common measurement, which uses less strict criteria, is resting metabolic rate (RMR).

Metabolic Acidosis

Metabolic acidosis is a condition that occurs when the body produces excessive quantities of acid or when the kidneys are not removing enough acid from the body. If unchecked, metabolic acidosis leads to acidemia, i.e., blood pH is low (less than 7.35) due to increased production of hydrogen ions by the body or the inability of the body to form bicarbonate (HCO3−) in the kidney. Its causes are diverse, and its consequences can be serious, including coma and death. Together with respiratory acidosis, it is one of the two general causes of acidemia. Terminology : Acidosis refers to a process that causes a low pH in blood and tissues. Acidemia refers specifically to a low pH in the blood. In most cases, acidosis occurs first for reasons explained below. Free hydrogen ions then diffuse into the blood, lowering the pH. Arterial blood gas analysis detects acidemia (pH lower than 7.35). When acidemia is present, acidosis is presumed. Signs and symptoms[edit] Symptoms are not specific, and diagnosis can be difficult unless the patient presents with clear indications for arterial blood gas sampling. Symptoms may include chest pain, palpitations, headache, altered mental status such as sev Continue reading >>

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  1. wordsmithe

    So I just came back from the doctor and her jaw literally dropped when she saw my cholesterol levels.
    My hdl was 90, but my LDL was 372. She told me to stop ketoing immediately and start taking cholesterol pills.
    Has anyone had such a high cholesterol level? If so, did you guys take medication?
    EDIT I've been reading a lot about high LDL levels and low TG levels and how there are different types of lipids in our blood. I'm not going to take the medication at this point and take a VAP test to see what kind of lipids are in my bloodstream.
    Also, I think it would be helpful to post some basic information.
    25 male 72 KG (159 lbs) 173 cm (5'9) Keto for six months Usual macros 45/45/10
    Keto helped me lose fat and gain muscle. I've been grateful for having keto guide me to a healthier lifestyle, but I'm willing to give it up if my heart is at risk.

  2. gogge

    Some people have issues with saturated fat, dietary cholesterol, or keto.
    Thomas Dayspring talks about a similar case (but with confirmed high LDL particle count) in one of his articles, I posted this in another thread:
    Some people react badly to saturated fat and dietary cholesterol (hyperresponders, longer post), they can probably still do keto (depends on how sensitive they are) just don't overdo the coconut oil, butter (eat more olive/avocado/canola oil instead) and cut down on eggs.
    Others might do better on just general non-ketogenic low carb, check out this article from Thomas Dayspring (a lipidologist referenced by Peter Attia and Gary Taubes) with a case very similar to yours (formatted for readability):
    “I started eating paleo/low-carb (with dairy) in Apr 2011. I should add that my diet has never been ultra low-carb -- just lower-carb than most people. My last blood test before going paleo was in Nov 2010 and my past numbers have always been similar:”
    Total cholesterol = 196
    LDL-C =105
    HDL-C = 75
    TG = 78 (all in mg/dL)
    TSH = 2.15
    “I lost 30 pounds in about 3 months and have kept it off ever since. Today I weigh 124 and maintain my weight easily eating this way, even though I am menopausal.”
    The lipid panel was repeated on the new diet:
    TC = 323
    LDL-C = 230
    HDL-C 83
    TG 49 (all in mg/dL)
    Total LDL-P = 2643 nmol/L (99 th percentile population cut point)
    TG/HDL-C = 0.59 (poor man’s marker of insulin sensitivity) Under 2.0 is excellent
    Not great changes, very high LDL cholesterol similar to your reaction, and this likely also means very high LDL particle count.
    Here's what they did:
    The dietary advice was to cut back on saturated fat and use more MUFA and PUFA without increasing carbs. After doing just that for a few months the patient reports:
    “The only modifications I've made because of my high lipids are eating steel cut oats regularly, adding chia seeds to my diet, and eating apples regularly (to increase fiber levels); cutting out most dairy; and watching my saturated fat intake a little more closely--all aimed at getting my high LDL-P down.” Weight has remained stable.
    Here are the follow up labs:
    TC = 178
    LDL-C = 92 (was 230)
    HDL-C = 82
    TG = 21
    Non-HDL-C = 96 (all inmg/dL)
    Total LDL-P: 948 nmol/L (recall it was grossly elevated at 2643) < 1000 nmol/L (20 th percentile population cut point) is desirable
    Small LDL-P: < 90 nmol/L (normal)
    LDL Size: 21.4 nm (quite large)
    CRP was near 0.
    Thomas Dayspring, "Lipidaholics Anonymous Case 291 Can losing weight worsen lipids?"
    The article is a very long read, but it's also absolutely excellent at explaining why some people can react badly and what to really look for in a lipid test, and what to do about it when things look bad.

  3. wordsmithe

    Thanks for the extensive response. Im definitely going to take some time today to do more reading and research. Im still 50/50 on taking the medication, but I do feel better knowing otbers have had similar reactions from keto.

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Anion gap usmle - anion gap metabolic acidosis normal anion gap metabolic acidosis

5.6 Metabolic Acidosis - Correction

The most important approach to managing a metabolic acidosis is to treat the underlying disorder. Then with supportive management, the body will correct the acid-base disorder. Accurate analysis & diagnosis is essential to ensure the correct treatment is used. Fortunately, in most cases this is not particularly difficult in principle. Remember though that a patient with a severe metabolic acidosis may be very seriously ill and even with optimal management the patient may not survive. The ECLS Approach to Management of Metabolic Acidosis 1. Emergency: Emergency management of immediately life-threatening conditions always has the highest priority. For example, intubation and ventilation for airway or ventilatory control; cardiopulmonary resuscitation; severe hyperkalaemia 2. Cause: Treat the underlying disorder as the primary therapeutic goal. Consequently, accurate diagnosis of the cause of the metabolic acidosis is very important. In some cases (e.g. methanol toxicity) there may be a substantial delay become the diagnosis can be confirmed so management must be based on suggestive evidence otherwise it will be too late. 3. Losses Replace losses (e.g. of fluids and electrolytes) whe Continue reading >>

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  1. TKInstinct

    I got out of the hospital yesterday, I had food poisoning and got admitted for Ketoacidosis. I feel a lot better now but, I'm in a little discomfort. My stomachs bothers me somewhat after I've eaten and I'm a little uneasy when I'm walking. I was in bed for a day and a half so I'm sure I'm just weak. But, did you recover right away or, did you take a day or two?

  2. hide

    Every time I'm in the hospital for DKA, I start to feel better around day 3. They never let me leave until day 5-7 though. :| So glad the last few times they've had wifi to watch Netflix on.

  3. NEXT_VICTIM

    3 days from start of IV fluids. When you get home, try to drink water instead of your usual fluids for a day or so. I find it helps get me back on track faster. Also, keep an eye on your BG a bit tighter for a few days after. The whole DKA resolution treatment and IV fluids can alter the way your BG floats (in some interesting ways) until you get back into your normal groove/routine.

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Inspired by Dr. Myat Soe, MD Internal Medicine Series: Clinical Clerkships Overview and Causes of Non-Anion Gap Metabolic Acidosis Made with help of Blueberry Flashback Recorder

Treatment Of Acute Non-anion Gap Metabolic Acidosis

Treatment of acute non-anion gap metabolic acidosis Medical and Research Services VHAGLA Healthcare System, Division of Nephrology, VHAGLA Healthcare System Correspondence to: Jeffrey A. Kraut; E-mail: [email protected] Search for other works by this author on: Clinical Kidney Journal, Volume 8, Issue 1, 1 February 2015, Pages 9399, Jeffrey A. Kraut, Ira Kurtz; Treatment of acute non-anion gap metabolic acidosis, Clinical Kidney Journal, Volume 8, Issue 1, 1 February 2015, Pages 9399, Acute non-anion gap metabolic acidosis, also termed hyperchloremic acidosis, is frequently detected in seriously ill patients. The most common mechanisms leading to this acidbase disorder include loss of large quantities of base secondary to diarrhea and administration of large quantities of chloride-containing solutions in the treatment of hypovolemia and various shock states. The resultant acidic milieu can cause cellular dysfunction and contribute to poor clinical outcomes. The associated change in the chloride concentration in the distal tubule lumen might also play a role in reducing the glomerular filtration rate. Administration of base is often recommended for the treatment of acute non-anion ga Continue reading >>

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  1. jjcj

    I keep reading about these strips but not sure where to get them or what to ask for. I am in Canada if that makes a difference.
    Thanks in advance for any and all help.

  2. Lekker

    Hi jjcj,
    I'm in Canada too, but I haven't found the strips...although I haven't looked very hard, I just browsed a couple drug stores, then gave up. I'm sure they're out there though - I heard that diabetics used to use them(?). So maybe if you explain at the drugstore to the pharmecist, they might know what you're talking about. Maybe they keep them behind the coutner. Froufy might be your best bet, though, for knowing what they might be called up here.
    To be honest, I can find nothing in Canada except for Splenda, so I've pretty much given up many of those things. Although maybe because I'm in Quebec it's a bit tougher to find some of these things??

  3. StarPrincess

    I'm assuming you're talking about the ketone testing strips? They come under lots of names and I've seen them range from $11 - $17 here in the states. There's frequently auctions on ebay for them.
    I personally don't use them anymore. They were fun for just "checking in" to see how I was doing, but I've since learned that I'm doing just fine and don't need to risk peeing on my hand to find out

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