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Metabolic Acidosis Definition

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

Metabolic Acidosis

Metabolic acidosis, defined as a venous pH < 7.35 is relatively common in dogs. The opposite condition is metabolic alkalosis. Metabolic acidosis is characterized by a decrease in plasma bicarbonate concentration < 18 mEq/L. It occurs as a result of loss of NaHCO3-rich fluids from the intestine or kidneys, increased acid production due to metabolism or reduced excretion of acids (anions). Causes include: Peritoneal dialysis Clinical signs often relate to underlying disease but depression and compensatory tachypnea may be observed. In metabolic acidosis a predisposition of cardiac abnormalities, particularly ventricular arrhythmia and ventricular fibrillation, can be observed. Treatment usually requires addressing underlying disease conditions and aggressive intravenous fluid therapy, usually with lactated Ringer's solution[11]. Only in patients with pH < 7.2, should NaHCO3 be added to the solution. In patients with respiratory acidosis secondary to hypoventilation, NaHCO3 therapy should be avoided because it inevitably decreases respiratory drive, thereby worsening acidosis and hypoxemia[12] As well, dogs with normochloremic metabolic acidosis caused by ketoacidosis are also less l Continue reading >>

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  1. mcs5309

    I have been eating low-carb paleo and IF 18/6 for the last 6 months and have been able to reduce some bodyfat which was the goal. I havbe a long way to go, so I added keto to the mix in the last couple weeks, increasing fat to about 65%, protein 30%, and carbs 5%.
    2 weeks prior to starting keto, my latest CMP showed elevated BUN (36 - ref range: 6-24), elevated BUN/Creatinine ratio (39 - ref range:9-20), and elevated urinary uric acid (1118.0 - ref range: 250.0-750.0). I also showed elevated serum calcium (10.9 - ref range: 8.7-10.2). My serum uric acid (UA), however, was normal (4.6 - ref range: 3.7-8.6) as is my creatinine (0.92 - ref range 0.76-1.27) and eGFR (95 - ref range >59). There is no protein in my urine. I do not have gout. These levels have gradually increased over the last 6 mos. I posted on my elevated BUN & uric acid recently: http://www.allthingsmale.com/forum/showthread.php?21082-Need-input-Elevated-BUN-urine-uric-acid
    Just yesterday noticed blood pressure remained elevated all day despite my usual BP-lowering supps. First time ever they had zero effect. I wonder if the increased intake of fats (SFAs) on the keto/low carb diet are causing this, as I have changed nothing else perhaps by increasing total cholesterol?
    http://www.ncbi.nlm.nih.gov/pubmed/9021429
    but this contradicts that:
    http://weightoftheevidence.blogspot.com/2006/02/what-does-saturated-fat-do-to-your.html
    Or could this be the beginning stages of kidney dysfunction, as it goes hand-in-hand with hypertension?
    According to this article, keto may help reduce BP, but may cause kidney stones, the very thing I'm trying to prevent from recurring:
    http://voices.yahoo.com/ketogenic-diets-help-control-blood-pressure-5349961.html
    More on keto and stones:
    http://perfecthealthdiet.com/2010/11/dangers-of-zero-carb-diets-iv-kidney-stones/
    http://www.ncbi.nlm.nih.gov/pubmed/17621514
    http://paleohacks.com/questions/14847/does-a-ketogenic-diet-cause-kidney-stones#axzz26twJurzQ
    And this excerpt from the Paul Jaminet link above explains my elevated uric acid as well:
    Uric Acid Production
    One difference between a ketogenic (or zero-carb) diet and a normal diet is the high rate of protein metabolism. If both glucose and ketones are generated from protein, then over 150 g protein per day is consumed in gluconeogenesis and ketogenesis. This releases a substantial amount of nitrogen. While urea is the main pathway for nitrogen disposal, uric acid is the excretion pathway for 1% to 3% of nitrogen. [7]
    This suggests that ketogenic dieters produce an extra 1 to 3 g/day uric acid from protein metabolism. A normal person excretes about 0.6 g/day. [8]
    In addition to kidney stones, excess uric acid production may lead to gout. Some Atkins and low-carb Paleo dieters have contracted gout.
    Perhaps I should cycle my protein intake as well as carbs? Increase fat even more?
    And what amount of water is recommended for low-carbers? Gallon/day?
    I'm at a loss as to what else I can do.
    Any feedback appreciated!

  2. seekonk

    The idea that this kind of diet is good for everyone is outdated. A significant percentage of people do worse on low-carb/high fat diets for genetic reasons. If you are interested, the SNPs are rs5082 (GG allele associated with worse health markers on high saturated fat diet), rs662799 (AA allele associated with higher BMI from diet with more than 30% fat), and rs1801282 (CC allele does not benefit from high monounsaturated fat diet w.r.t. BMI).

  3. mcs5309

    seekonk said: ↑
    The idea that this kind of diet is good for everyone is outdated. A significant percentage of people do worse on low-carb/high fat diets for genetic reasons. If you are interested, the SNPs are rs5082 (GG allele associated with worse health markers on high saturated fat diet), rs662799 (AA allele associated with higher BMI from diet with more than 30% fat), and rs1801282 (CC allele does not benefit from high monounsaturated fat diet w.r.t. BMI). Thanks. Where can one get these tests done? Regular labs like Labcorp and Quest don't do them.

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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

The low HCO3- in metabolic acidosis results from the addition of acids (organic or inorganic) or from a loss of HCO3-; causes of metabolic acidosis are classically categorized by presence or absence of an increase in the anion gap (Table 1-6). Increased anion-gap acidosis (>12 mmol/L) is due to addition of acid (other than HCl) and unmeasured anions to the body. Common causes include ketoacidosis (diabetes mellitus [DKA], starvation, alcohol), lactic acidosis, poisoning (salicylates, ethylene glycol, and methanol), and renal failure. TABLE 1-6: METABOLIC ACIDOSIS Non-Anion-Gap Acidosis Anion-Gap Acidosis Cause Clue Cause Clue Diarrhea enterostomy RF RTA Proximal Distal—hypokalemic Distal—hyperkalemic Distal—hyporeninemic hypoaldosteronism Dilutional Ureterosigmoidostomy Hyperalimentation Acetazolamide, NH4Cl, lysine HCl, arginine HCl, sevelamer-HCl Hx; ↑ K+ drainage Early chronic kidney disease ↓ K+, presence of other proximal tubular defects (Fanconi syndrome) ↓ K+; hypercalciuria; UpH >5.5 ↑ K+; nl PRA/aldo; UpH >5.5 ↑ K+; ↓ PRA/aldo; UpH <5.5 Massive volume expansion with saline Obstructed ileal loop Amino acid infusion Hx of administration of these agents DKA Continue reading >>

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  1. [deleted]

    I have had a terrible time sleeping since being on Keto, specifically in the last week. I do not want to stop though, I've lost 8 lbs in 24 days, I'm starting to PR more, and there are moments of clarity where the brain fog is at a minimum.
    NOTHING seems to keep me asleep. Usually I fall asleep in seconds and wake up 4 hours later wide awake but now I cannot even fall asleep. I try not to drink too much water before bed, exercise earlier in the afternoons 2-4 times a week, keep the tv/ smartphone out of the bedroom, and give myself some wind down time. I take the lowest does of Topamax for headaches and Alteril as a sleep aid. Any advice? Does this go away? I've been on some psych meds before for sleep, but none of them are truly designed to keep you asleep, only help you fall asleep.
    If you have any suggestions, I'd really appreciate it. I'm taking in about 70-90 grams of protein per day to keep my muscle mass, but I may have to down grade as protein can keep you awake.
    Thanks for any help you can give me.

  2. DownhillYardSale

    I've been on some psych meds before for sleep, but none of them are truly designed to keep you asleep, only help you fall asleep.
    Why?
    If this is the case keto isn't the cause of your sleep problems.
    I'm immediately looking towards stress/anxiety.

  3. DownhillYardSale

    You do not need to have mental health issues for stress/anxiety to affect your sleep.
    Any significant changes recently other than completely changing your diet?

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In this video I discuss what is metabolic rate, how to calculate metabolic rate, and how to calculate calories burned, and how many calories burned in a day. I also discuss basal metabolic rate, and resting metabolic rate. Transcript (partial with notes) In this video, I am going to show you the formula on how to calculate your calories burned in a day (metabolic rate). And give some examples. Lets start off with the term metabolic rate. In this video we are defining metabolic rate as the amount of calories you would burn off in a day (24 hours) while at rest. So, not moving around or being active. In the fitness community, There are 2 popular formulas to calculate this. BMR, basal metabolic rate, and RMR, resting metabolic rate. BMR is taken after 8 hours of sleep and 12 hours of fasting. RMR is taken under less restrictions, and has been shown to be statistically more accurate. Lets look at a couple of examples. Here we have kyle and Samantha, and their metrics are here. Kyle is 44 yrs old, is 58 tall, and weighs 160 pounds. Samantha is 33 yrs old, 54 tall, and weighs 126 pounds. The RMR equation for men is (4.55 x Weight in pounds) + (15.88 x Height in inches) - (5*age) + 5, for women the equation is (4.55 x Weight in pounds) + (15.88 x Height in inches) - (5*age) -161. When we plug in Kyles and Sams #s, we see that Kyles RMR is 1592.84 cal/day, and Sams is 1263.62 cal/day. So, after rounding up, this tells us that if Kyle and Sam were to sit around all day, they would need 1583 and 1264 calories per day to maintain their weights. We know that neither Kyle or Samantha are going to sit around all day. So there is a multiplication factor that we must use next. It is based on each of their lifestyles. The factor is as follows 1.200 = sedentary (little or no exercise) 1.375 = lightly active (light exercise/sports 1-3 days/week, approx. 590 Cal/day) 1.550 = moderately active (moderate exercise/sports 3-5 days/week, approx. 870 Cal/day) 1.725 = very active (hard exercise/sports 6-7 days a week, approx. 1150 Cal/day) 1.900 = extra active (very hard exercise/sports and physical job, approx. 1580 Cal/day) Lets say Kyle is very sedentary, so if we multiply his RMR by 1.2 we have .1911.6 cal/day. Now, Samantha is in the very active category, so we need to multiply her RMR by 1.725, and we get2180.4 cal/day . So, based on these calculations Kyle can consume 1912 calories per day to maintain his current weight, and Samantha can consume 2180 calories per day to maintain her weight. Now, You can use the RMR equation and lifestyle multiplication factor to calculate your baseline. Drawbacks A few of things I need to mention. First, this and any other formula used to calculate your metabolic rate is just an estimate. There is a margin for error. Second, muscle mass is very important. Lets look at Kyle, and Jack, who both weigh the same. However, Jack has much more muscle mass than K, since muscle burns more calories than fat, J will have a higher metabolic rate. Third, the type of diet ( for example consuming whole vs processed foods) is not factored either. Bottom Line I dont believe that counting calories is a path to successfully sustaining weight loss in the long run. However, Using the RMR formula and the lifestyle multiplication factor is extremely helpful in increasing your awareness to how many calories you need to consume per day. Which In turn can lead to a higher awareness of how quickly calories you consume add up. Other sources... http://www.scientificpsychic.com/heal... http://www.ncbi.nlm.nih.gov/pubmed/15...

Metabolic Acidosis

acidosis and bicarbonate concentration in the body fluids resulting either from the accumulation of acids or the abnormal loss of bases from the body (as in diarrhea or renal disease) In medicine, metabolic acidosis is a condition that occurs when the body produces too much 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 due to increased production of hydrogen by the body or the inability of the body to form bicarbonate 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. The numerical value of metabolic acidosis in Pythagorean Numerology is: 6 Use the citation below to add this definition to your bibliography: Continue reading >>

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  1. Robertus

    Hi. I learned a very little bit about ketosis many years ago but have never tried to follow a long-term ketogenic diet. I have, however, done some fasting and long-distance swimming in my weight loss journey and I am wondering if 'exercise-induced ketosis' is a thing?
    I do not have a target weight, at least not yet, anyway, and weight loss is not my primary goal, but it is, of course, desirable and a secondary goal to my primary fitness goals.
    I was struck by this passage from Marcia Cleveland's book, Dover Solo: Swimming The English Channel. She doesn't have medical or physiological training, but practical experience in swimming very long distances.
    [Mike Oram, pilot of an escort boat for channel swimmers] suggested that I go into my long pool swims on an empty stomach so my body would learn how to burn fat effectively. Since I did not eat before my morning workouts I was already doing this, thus simulating the physiological condition after swimming for a few hours. My system was already learning to switch over from its initial stores of carbohydrates and glycogen to fats right from the start of a swim."
    I have also done this, I think with some success. It is certainly not a way to cheat the basic mathematics of CICO, but I'm thinking it may be a way to get your body into ketosis more aggressively than merely fasting. It seems to be essentially what what many marathon runners describe as 'hitting the wall' around the 23-mile mark. Since I too have no medical or physiological expertise, I do not recommend it too others, but I do it myself sometimes, about once or twice a week on long swims of 3 miles after not eating that morning, or sometimes not even the day before, at least not much. A couple of times, it was a little scary afterward (ie, feeling like I might faint, dry heaves, tingling in my fingers), and I needed to sit still for quite a while before I started to feel normal again. Later on I always follow up with a big dose of protein (steak or lobster) for the rest, restoration, and rebuilding phase. I now sometimes also eat a protein bar before I do this, at the recommendation of a pharmacist friend.
    A couple of articles I saw today also seem to indicate that longer-term moderate intensity aerobic exercise may burn calories more effectively than higher levels. Obviously, moderate levels of aerobic intensity can be sustained for a much greater length of time. I call this swimming in an aerobic loop, where it feels like you can almost effortlessly increase distance just by increasing the time of the work-out. Here are the articles I'm referring to:
    Anne Bach Stisen, Ole Stougaard, Josef Langfort, Jørn Wulff Helge, Kent Sahlin, Klavs Madsen. Maximal fat oxidation rates in endurance trained and untrained women. European Journal of Applied Physiology. November 2006, Volume 98, Issue 5, pp 497-506
    Training-induced adaptation in muscle fat oxidative capacity.
    The highest rates of fat oxidation occur at moderate exercise intensity, ie, 56% VO2max for endurance trained athletes and 53% for untrained people.
    http://link.springer.com/article/10.1007/s00421-006-0290-x
    Stefano Lazzer, Carlo Busti, Fiorenza Agosti, Alessandra De Col, Renzo Pozzo, Alessandro Sartorio. Optimizing fat oxidation through exercise in severely obese Caucasian adolescents. Clinical Endocrinology. Volume 67, Issue 4 October 2007 Pages 582–588
    Severely obese and sedentary nonobese adolescents reached maximal fat oxidation rates at 41%V̇O2max, which corresponds to 58% HRmax.
    http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2265.2007.02929.x/full
    By the way, the reason I have not tried to follow a sustained ketogenic diet is that increasing fitness and endurance is a more important goal for me than weight loss. And this seems to be aided by eating back a lot of exercise calories (not all) after long work-outs when my body is in rest and rebuilding phase. Maybe this can also be done by eating mostly protein and fat during this phase, but I tend to just eat what I like! Nonetheless, I have lost 60 lbs in the first 3 months of my 'dieting' phase, which I started doing after first starting to work on basic fitness for about a month.
    Thoughts? Resources?
    PS: Please feel free to add me as a friend. You can never have too many good friends!

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