Do Low-carb Diets Increase Kidney Stone Risk? Let’s Ask The Low-carb Experts
People have all sorts of ideas about low-carb diets based on what they’ve heard somewhere or just on what they think they know about them. It’s why concepts like “artery-clogging” saturated fats still pervade our culture despite all the scientific evidence to the contrary. It doesn’t help that these myths surrounding healthy carbohydrate-restricted diets are perpetuated on a daily basis by so many so-called health “experts” in both the medical and nutrition fields and the general public is none-the-wiser to contradict any of it since they are merely living their lives and trusting the sources of information they are paying attention to. It’s what makes the idea of creating a cultural shift in thinking in favor of low-carb living that much more difficult–but it won’t deter me or the many others who are out here fighting the good fight to educate, encourage and inspire others to give livin’ la vida low-carb a try for themselves. I literally receive hundreds upon hundreds of e-mails daily from readers who are searching for answers to their questions about their low-carb lifestyle, help with weight loss, or managing some chronic disease they are dealing with. Although I’m not a doctor or nutritionist, I’m always happy to share from my own experiences to see if that information can be beneficial to the person who wrote to me. It’s my pleasure to hear from readers and to offer up assistance in any way that I can. However, from time to time I’ll receive an e-mail from a reader who has an interesting question that is beyond my scope of full understanding enough to share a detailed explanation of what’s possibly going on. It’s okay that I don’t know everything there is to know about nutrition and it’s relationship to being healthy. The good Continue reading >>
- Popular gluten-free diets increase diabetes risk – research
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Are Ketogenic Diets Bad For People With Kidney And Liver Issues?
There is an international organization of doctors and other professionals who have clinical experience with ketogenic diets. It's called the International Ketogenic Diet Study Group. They publish guidelines for safe use of ketogenic diets. The guidelines include a list of medical conditions (contraindications) which would make a ketogenic diet unsafe. At least one of the conditions on the list (carnitine deficiency) can cause liver dysfunction. You don't say exactly what sort of liver problem you have in mind. If you personally have a disease that affects the liver, maybe you should look at the list of contraindications carefully. Another condition on the list, beta-oxidation defects, can cause the liver to lack the ability to oxidize fatty acids. Regarding this condition the guidelines say, "An inborn metabolic error at any point along this pathway can lead to a devastating catabolic crisis (i.e., coma, death) in a patient fasted or placed on a [ketogenic diet]." Ketogenic diets increase the risk of kidney stones. Doctors often prescribe potassium citrate to people on medical ketogenic diets as a prophylactic measure against kidney stones. Here is a link to the full text of the guidelines. Contradindications are in Table 2. The title says "children" because virtually all clinical experience with ketogenic diets has been with kids. If you want to read more about the risks of ketogenic diets, click here to see a bibliography on my website (with many links to full text) of articles about risks and prevention. Some people seem to believe that ketogenic diets are harmless, risk-free, totally wonderful things. This isn't true. Ketogenic diets are like medications. They bring benefits but they also bring risks and harmful side effects. They involve tradeoffs. I'm not against Continue reading >>
Urine Test Types: Ph, Ketones, Proteins, And Cells
Urine as a Diagnostic Tool A long time ago, disgusting as it may be, people used to actually taste and drink urine in order to try and diagnose a patient's disease! I'm not even kidding you. Thankfully, modern-day doctors do not have to resort to such disgusting and even dangerous methods. One of the reasons the doctor barbers of yesteryear used to drink their patient's urine was to see if it had a sweet taste, often indicative of diabetes mellitus. Finding the sweet-tasting glucose in the urine was covered in detail in another lesson, so we'll focus on other important measurements here instead. Interpreting Urine pH One value that can be measured in the urine is known as urine pH. pH is a measure of the acidity or alkalinity of a substance. If the pH is low, then it is acidic. If the pH is high, then it is basic, or alkaline. To remember which is which, I'll give you a little trick that has worked for me. If you grew up watching cartoons, you probably saw some comical ones where cartoonish robbers poured acid on the roof of a bank vault and waited while the acid ate its way downward into the vault, so the robbers could get down there to steal all the cash. If you can recall that acid likes to eat its way downward into things, then you'll remember that acidic substances go down the pH scale. That is to say, their pH numbers are lower than basic substances. Normal urine pH is roughly 4.6-8, with an average of 6. Urine pH can increase, meaning it will become more basic, or alkaline, due to: A urinary tract infection Kidney failure The administration of certain drugs such as sodium bicarbonate Vegetarian diets On the flip side, causes for a decreased, or acidic, urine pH, include: Metabolic or respiratory acidosis Diabetic ketoacidosis, a complication of diabetes mellitus Continue reading >>
Does A Ketogenic Diet Cause Kidney Stones?
I remember the first time I learned about the connection between a diet high in sugar and gout, kidney stones and heart disease. I was reading a book (I don’t remember which one) that was laying out the evidence that showed a clear link between sugar consumption and those diseases and it immediately peaked my interest because I didn’t know that gout was still a thing. I had only heard of old French monarchs having it and honestly didn’t know it was still around until just a few weeks before reading that book. Just a few weeks prior to reading that, I learned that my son’s Father in Law had gout and occasional kidney stones and as I read that passage in the book, I thought about calling him and telling him what I read. I decided against it and figured I would bring it up the next time I saw him at church. Unfortunately, before I ever got a chance to say anything to him, he had a heart attack. He’s fine now but I have always felt bad I didn’t immediately make a call. I realize it wouldn’t have done much given how quickly it all happened but still, I should have said something. Since then, probably the most common question I get about the ketogenic diet is whether or not it will cause kidney stones and there is definitely a connection but possibly not how you think. First let’s go over how kidney stones are formed. How Kidney Stones are Formed At one point in time it was thought that uric acid was produced solely from the breakdown of purines found in foods like liver, pork, mushrooms, anchovies, mackerel and dried beans which is why most patients that were susceptible to kidney stones or gout were put on a low purine diet. Unfortunately those diets didn’t work too well and almost always had to be supplemented with additional medications that controlled t Continue reading >>
Steve Phinney And Richard Johnson: Ketones, Uric Acid, High Fat And Health
Note from Steve Phinney: What this shows is that uric acid goes up promptly in the same time frame that ketones go up, but after 4-6 weeks, despite ketones staying up, uric acid starts to come back down. Based on these data and my clinical observations in thousands of patients, uric acid returns to or below pre-diet baseline within 6-12 weeks despite the person remaining is a state of nutritional ketosis. Thus, when I’m asked how long ketoadaptation aks, I generally respond that some aspects of it take 6 weeks or more. This graph, by the way, shows blood uric acid levels from the untrained subjects (VT) and bicycle racers (MIT) at various times over 4-6 weeks of sustained carbohydrate restriction (aka keto-adaptation). LISTEN (50 Minutes) EDITOR’S NOTE: Sometimes, the divide between experts who advise against a high-fat, low-carb diet and those who recommend it seems larger than the Grand Canyon. But occasionally, top thinkers from both sides break through to discover common ground, along with new paths for exploration. With that in mind, here’s a discussion between two nationally recognized health researchers which refers to the uric data in this chart . . . and more. To see the charts in larger format, click on them, and they should enlarge. Before going to the transcripts of this interview, here’s more background: Dr. Steve Phinney is emeritus professor of medicine at UC-Davis and a world-renowned expert on high fat diets, including how they affect uric acid levels. Dr. RIck Johnson is a professor of medicine at the University of Colorado who’s an expert on fructose metabolism (fructose accounts for much of the sweetness in table sugar and in high fructose corn syrup). Johnson’s expertise on fructose ties him back to uric acid. Johnson writes: “Our work Continue reading >>
Resist The Dark Side And Easily Shift Into Ketosis
Four years ago, I realized that I’d been duped. I’d been lied to about carbohydrates. Despite obtaining a graduate degree with advanced courses in human nutrition, biochemistry, microbiology, and exercise physiology, a sports nutritionist certification, and plenty of time with my face stuffed in dietary research journals, I was simply doing things completely back-asswards when it came to fueling my body. See, my physical performance on my “gold-standard” 50-60% carbohydrate intake was just fine. Performance wasn’t an issue. I was quite competitive and very fast in my triathlons, runs, swims, bike rides, and workouts. But I also had bloating. Gas. Fermentation. Wildly fluctuating energy levels. Extra bits of fat around my belly and hips. Inflammation. All the warning signs of high blood glucose. All the signs that I was sacrificing health and longevity for performance…all the issues I talk about in gory detail in my book Beyond Training. So I simply gave a finger to dyed-in-the-wool, orthodox sports nutrition advice that trickles down from companies like Gatorade, Powerbar, and the US Government’s Food Pyramid. I took a deep, deep dive into a more ancestral, natural form of eating. I started eating more greens. More vegetables. More nutrient-dense plants. And I combined those plants with oodles of healthy, natural fats like avocadoes, olive oil, coconut milk, seeds, nuts, fatty fish, grass-fed meats, and yes, even “weird” foods like bone broth, liver, sardines and many of these unorthodox meals and pantry foods. I began eating the “cyclic” low-carbohydrate diet that I outline in my book on low carbohydrate eating for athletes, meaning that I would save the majority of my carbohydrate intake for the very end of the day, and even then, I ate the clean Continue reading >>
What To Do If You Have Ketones
I woke up pretty late today, around 11am. I really didn’t feel like getting up at all because I was still really tired. I was woken up by a ringing house phone that I ignored, then a cell phone with my husband on the other end. Then my mom coming downstairs to get the laundry and reminding me that we were going out today. (I live in my parents basement apartment.) “Ok, Ok… I am getting up” I tell her. I took in a big yawn and stretch of the arms. Then I actually got up out of my bed. I felt weird but I just thought it was because I got out of the bed too quickly. I tried to lick my lips together, but I had no saliva in my mouth - it was like the Mojave desert in there. I went to the bathroom to wash up because now my mom was getting antsy and rushing me. Don’t you just love getting up like that? Anyway, I started to feel a bit nauseated after about 20 minutes. I know these symptoms all too well. Dry mouth, Nausea = High blood sugar or Ketones. So, I checked my blood sugar. 3 2 1 334. Oh boy. Ok, umm… how did this happen? I didn’t really eat anything high carb last night? I went to bed with a pretty decent number and I just changed my infusion set. I don’t feel sick. My pump site isn’t hurting. It really boggled my mind. I felt my heart race a bit and started feeling panicky, and my breathing was getting heavier. Can you say panic attack? I always get a little paranoid though, it’s just my thing. Anyway, I told myself “Ok, Gina just calm down, you know what to do.” So I did my thing. I went back into the bathroom and grabbed my Ketostix to check my urine for Ketones. This is something I do when I have an unexpected high blood sugar with nausea. My urine test came out with Large, the highest level. Ugh. Ketones on the back of the bottle start out w Continue reading >>
The Keto Diet Is Gaining Popularity, But Is It Safe?
A new twist on extreme weight loss is catching on in some parts of the United States. It’s called the "keto diet." People promoting the diet say it uses the body’s own fat burning system to help people lose significant weight in as little as 10 days. It has also been known to help moderate the symptoms of children with epilepsy, although experts are not quite sure why it works. Proponents say the diet can produce quick weight loss and provide a person with more energy. However, critics say the diet is an unhealthy way to lose weight and in some instances it can be downright dangerous. Read More: What is the “Caveman Diet?” » What Is Ketosis? The “keto” diet is any extremely low- or no-carbohydrate diet that forces the body into a state of ketosis. Ketosis occurs when people eat a low- or no-carb diet and molecules called ketones build up in their bloodstream. Low carbohydrate levels cause blood sugar levels to drop and the body begins breaking down fat to use as energy. Ketosis is actually a mild form of ketoacidosis. Ketoacidosis mostly affects people with type 1 diabetes. In fact, it is the leading cause of death of people with diabetes who are under 24 years of age. However, many experts say ketosis itself is not necessarily harmful. Some studies, in fact, suggest that a ketogenic diet is safe for significantly overweight or obese people. However, other clinical reviews point out that patients on low-carbohydrate diets regain some of their lost weight within a year. Where It’s Helpful The keto diet was created by Dr. Gianfranco Cappello, an associate professor of surgery at the Sapienza University in Rome, Italy. He claims great success among thousands of users. In his study, more than 19,000 dieters experienced significant, rapid weight loss, few side Continue reading >>
High Anion Gap Metabolic Acidosis Induced By Cumulation Of Ketones, L- And D-lactate, 5-oxoproline And Acute Renal Failure
Introduction: Frequent causes of high anion gap metabolic acidosis (HAGMA) are lactic acidosis, ketoacidosis and impaired renal function. In this case report, a HAGMA caused by ketones, L- and D-lactate, acute renal failure as well as 5-oxoproline is discussed. Case presentation: A 69-year-old woman was admitted to the emergency department with lowered consciousness, hyperventilation, diarrhoea and vomiting. The patient had suffered uncontrolled type 2 diabetes mellitus, underwent gastric bypass surgery in the past and was chronically treated with high doses of paracetamol and fosfomycin. Urosepsis was diagnosed, whilst laboratory analysis of serum bicarbonate concentration and calculation of the anion gap indicated a HAGMA. L-lactate, D-lactate, β-hydroxybutyric acid, acetone and 5-oxoproline serum levels were markedly elevated and renal function was impaired. Discussion: We concluded that this case of HAGMA was induced by a variety of underlying conditions: sepsis, hyperglycaemia, prior gastric bypass surgery, decreased renal perfusion and paracetamol intake. Risk factors for 5-oxoproline intoxication present in this case are female gender, sepsis, impaired renal function and uncontrolled type 2 diabetes mellitus. Furthermore, chronic antibiotic treatment with fosfomycin might have played a role in the increased production of 5-oxoproline. Conclusion: Paracetamol-induced 5-oxoproline intoxication should be considered as a cause of HAGMA in patients with female gender, sepsis, impaired renal function or uncontrolled type 2 diabetes mellitus, even when other more obvious causes of HAGMA such as lactate, ketones or renal failure can be identified. Continue reading >>
Diabetic Ketoacidosis
Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Pre-diabetes (Impaired Glucose Tolerance) article more useful, or one of our other health articles. See also the separate Childhood Ketoacidosis article. Diabetic ketoacidosis (DKA) is a medical emergency with a significant morbidity and mortality. It should be diagnosed promptly and managed intensively. DKA is characterised by hyperglycaemia, acidosis and ketonaemia:[1] Ketonaemia (3 mmol/L and over), or significant ketonuria (more than 2+ on standard urine sticks). Blood glucose over 11 mmol/L or known diabetes mellitus (the degree of hyperglycaemia is not a reliable indicator of DKA and the blood glucose may rarely be normal or only slightly elevated in DKA). Bicarbonate below 15 mmol/L and/or venous pH less than 7.3. However, hyperglycaemia may not always be present and low blood ketone levels (<3 mmol/L) do not always exclude DKA.[2] Epidemiology DKA is normally seen in people with type 1 diabetes. Data from the UK National Diabetes Audit show a crude one-year incidence of 3.6% among people with type 1 diabetes. In the UK nearly 4% of people with type 1 diabetes experience DKA each year. About 6% of cases of DKA occur in adults newly presenting with type 1 diabetes. About 8% of episodes occur in hospital patients who did not primarily present with DKA.[2] However, DKA may also occur in people with type 2 diabetes, although people with type 2 diabetes are much more likely to have a hyperosmolar hyperglycaemic state. Ketosis-prone type 2 diabetes tends to be more common in older, overweight, non-white people with type 2 diabetes, and DKA may be their Continue reading >>
Ketone Supplements: More Harm Than Good?
Enjoy this article co-authored with my dear friend, Tatiana Schallert, who is co-serving with me, my ministry, and my family. I AM Love, Dr. Sharnael Have you noticed that Ketone supplements are so popular recently? I know my Facebook newsfeed is buzzing with different articles and brands promoting ketones. I honestly had no clue what the deal was so I decided to do some research, which is exactly what I encourage you to do before jumping on the bandwagon. There is a lot of information out there on this topic right now and from what I found – taking Exogenous Ketones may be more harmful than good. What are Ketones? Ketones are produced in the liver from fatty acids. Then they are consumed as alternative fuel by the body, particularly the brain, when blood sugar (glucose) is in short supply. The brain consumes lots of energy every day and it can’t run on fat directly – only in the form of glucose or ketones. Ketones are popularly known as “brain fuel.” Eating a no-carb, moderate-protein, and high-fat diet encourages the body to organically reach a state of Ketosis. It takes about 72 hours for the liver to be in full ketosis so the kidney can assimilate the changes as the ketones gradually increase. Then it takes about two weeks for your body to adjust to the new pathway. What Is Ketosis? When the body produces ketones it’s said to be in ketosis (you can test ketone levels through urine tests). The fastest way to get there is by fasting. However, fasting is not something we do forever. On the other hand, a low-carb or “keto” diet also leads to ketosis and is a more sustainable option. The idea of a ketogenic diet is to get the body to switch its fuel supply to run almost entirely on fat. As insulin levels become very low, fat burning increases dramatically Continue reading >>
Diabetic Ketoacidosis
As fat is broken down, acids called ketones build up in the blood and urine. In high levels, ketones are poisonous. This condition is known as ketoacidosis. Diabetic ketoacidosis (DKA) is sometimes the first sign of type 1 diabetes in people who have not yet been diagnosed. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin shots, or surgery can lead to DKA in people with type 1 diabetes. People with type 2 diabetes can also develop DKA, but it is less common. It is usually triggered by uncontrolled blood sugar, missing doses of medicines, or a severe illness. Continue reading >>
Beware Exogenous Ketones
There are three ways to raise blood levels of ketones and obtain the potential benefits from them: physiological ketosis via strict carbohydrate limitation or fasting; supplementation of medium-chain triglyceride (MCT) oils that are metabolized in the liver to ketones; and actually taking the ketone, beta-hydroxybutyrate. In this Undoctored Blog post, I’d like to discuss exogenous ketones. While fascinating with potential for substantial health benefits, there are some very real dangers with the current products on the market, so much that I have reported two of the products to the FDA. This is part of the expanded health discussion I begin in the new Undoctored book, Undoctored: Why Health Care Has Failed You and How You Can Become Smarter Than Your Doctor, with a comprehensive discussion of all aspects of ketosis in the Undoctored Inner Circle Advanced Concepts, the membership site for the truly serious Undoctored follower. You will also find a brief conversation about what I call “Assisted Fasting” using MCT oils in this video. Early research on supplemental exogenous ketones demonstrated fascinating effects, such as protection from hypoglycemia (as ketones are an alternative source of brain energy), protection from seizures (including in Navy seals who breathe high levels of oxygen that can cause fatal underwater seizures), and improved aerobic performance in trained athletes. More recent research has uncovered or confirmed additional effects of supplemental exogenous ketones: Improved endurance and aerobic performance in athletes—-Indeed, many professional athletes are supplementing exogenous ketones. Modest increase in muscle growth with exercise; less muscle lost with weight loss Greater fat burning (oxidation) during exercise, less reliance on glycogen/s Continue reading >>
Of The Keto Diet?
There are many awesome benefits that come with adopting a low-carb ketogenic diet, such as weight loss, decreased cravings and even possibly reduce disease risks. With that being said, it’s also good to talk about possible ketosis side-effects when ingesting these specific ketone supplements, so you know fully what to expect when you get started on this mission. If you’ve already heard about some of the side-effects that come with this special diet and are starting to freak out, don’t panic. We’re going to break down everything you need to know when it comes to what your body will experience when using these supplements for the first time. It’s important to remember, not everyone experiences side-effects when starting a ketogenic diet and thankfully, the symptoms are all very temporary and it can pass very quickly. It varies with the individual, but just to make sure all your bases are covered, we’re going to break down each possible side effect that you could possibly experience. 1. Flu Symptoms Within the first 2-4 days of beginning this diet, a common side-effect is known as the “ketosis flu” or “induction flu” because it mimics the symptoms of the actual flu. This means you might experience: Headaches Lethargy Lack of motivation Brain fog or confusion Irritability Although these symptoms typically go away completely within a few days, they are also completely avoidable if you stay very hydrated and increase your salt intake and like always, be sure you're eating enough fat. 2. Dizzyness & Drowsiness As you start dumping water, you'll lose minerals such as salt, potassium and magnesium. Having lower levels of these minerals will make you tired, lightheaded or dizzy. You may also experience muscle cramps, headaches and skin itchiness. Fatigue Continue reading >>
Blood In The Urine
Your child’s urine tests positive for blood during an annual physical. You’re understandably anxious and concerned. Most of the time blood in the urine is not a problem -- but occasionally it is. Dr. John Foreman, a pediatric kidney specialist, explains when an appointment with a specialist is needed. Studies in the United States, and other parts of the world, have examined large numbers of children and have found that hematuria, the medical term for blood in the urine, is a relatively common finding. In fact, two to five percent of school age children had tiny amounts of blood in their urine at some point in time during every day. About one percent of school-aged children continue to have blood in their urine when it is repeatedly tested. While this might seem scary, most causes of hematuria are harmless. Only a very few children who continued to have hematuria had serious kidney problems. The vast majority remained perfectly healthy and the blood disappeared after a number of years. Usually the blood cannot be seen with the naked eye and can only be detected in the laboratory using a special urine dipstick that measures blood, protein, sugar, ketones, and products from bacterial infection. The urine dipsticks are very sensitive and turn positive with tiny amounts of blood that may be seen only when the urine is observed under the microscope (called microscopic hematuria). Most of the time blood in the urine causes no pain to your child. Even when blood is visible to the naked eye, it is very rarely a lot of blood, so you don’t have to worry about your child losing too much blood. Causes of Blood in the Urine Besides kidney problems, there are other causes of hematuria. The tests that your doctor may perform depend on whether there are other findings from the uri Continue reading >>
