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Sodium Bicarbonate Intracellular Acidosis

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Sodium Bicarbonate - An Overview | Sciencedirect Topics

Jamie McElrath Schwartz, ... Donald H. Shaffner, in Smith's Anesthesia for Infants and Children (Eighth Edition) , 2011 Sodium bicarbonate causes an acid-base reaction in which bicarbonate combines with hydrogen ion to form water and carbon dioxide, resulting in an elevated blood pH: Because sodium bicarbonate generates CO2, adequate alveolar ventilation must be present before its administration. As respiratory failure is the leading cause of cardiac arrest in children, caution should be taken before sodium bicarbonate administration in the face of preexisting respiratory acidosis. Sodium bicarbonate use during CPR is one of the most controversial issues in the literature related to cardiac arrest. This stems from lack of evidence of benefit during CPR in animals and humans, as well as the potential adverse effects associated with sodium bicarbonate administration. Literature on sodium bicarbonate use in CPR dates back to the 1960s, but there are little data demonstrating a beneficial impact on human survival (Levy, 1998). In animal models of resuscitation from cardiac arrest, sodium bicarbonate has been associated with increased survival in few studies and with no difference in s Continue reading >>

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  1. xenia

    I have a few questions about a ketogenic diet.
    1) Lately, I have probably been eating less than 50 grams of carbs a day. Is this ketogenic?
    2) If someone is on a ketogenic diet, does this require urine testing at home? Is this suggested or necessary? Do you?
    3) Are there known risks for being on a severely carb restricted diet that one should be aware of?
    I seriously dont want to "hassle" with counting carbs, so I've thought to myself I will cut out the obvious ones then I wont have to count. Most recently, I've eliminated breads, rice, pototoes, sweets, and only eat carbs that end up in nuts, yogurt, low carb veggies, berries, etc. So based on that I am guessing that I eat 60 g of carbs a day, or less. Possibly much less on many days.
    Today for breakfast, I had scrambled eggs with sauteed peppers, and chedder cheese.
    Lunch was a small bowl of broccoli cheddar soup, with less than 10 grams of carbs (per the container)
    Supper was a 7 oz hamburger with about 3/4 cup strawberries. It was an early supper so I will have some Greek yogurt with nuts or something later.
    How does that sound?
    Yesterday, for breakfast I had a chocolate protein drink and 3 brazil nuts
    Lunch - turkey lunch meat, a couple slices of cheddar cheese, and a big handful of grape tomatoes.
    Now here is the clincher: For supper, I made some homemade "chicken pot pie mixture" and I didnt have it with the biscuit on top. I knew that I put flour in there, to thicken the sauce, and peas and carrots with carbs. I knew it was not a pristine choice (my husband couldnt stop raving, of course) I think it was the "Pizza Effect" I've heard about through this support community, as my BG didnt rise too much immediately after that - 118 at one hour, and 96 at two hours I was shocked, actually. But when I went to bed, it was 128! (I realize that it could have risen, "just because" as well.) For me, at that hour, that was a lot. And then all day today, higher than normal, even with low carb eating and a 30 minute walk.
    So I feel like I HAVE to basically eliminate most carbs from my life to maintain AS NEAR TO NORMAL NUMBERS AS POSSIBLE - is my goal. My ideal would be most of the day, under 100. Which means a very low carb, or ketogenic ? diet.
    Which is why I need to know more, from your perspective, about this diet. I LOVE my doctor, he's the greatest, but he is still suggesting 40 g of carbs at each meal. We've had plenty of discussion about that mindset. My dietician, too.
    So what do YOU think about a ketogenic diet - its safety, whether you need to test your urine for ketones, what numbers of carbs actually constitute a ketogenic diet? Does what I am doing sound like a ketogenic diet (minus the pot pie, no biscuit?)

  2. lowcarbwalking

    Hi Xenia,
    Here is my experience with doctors and a ketogenic diet:
    1. Internal medicine doctor who diagnosed me with diabetes:
    She had one patient who used the Keto eating method and it worked/s for him. She did not know enough about it to tell me how to do a ketogenic diet. She said, find info on the the web or get a book.
    2. My longtime endocrinologist:
    WHAT!?! A Keto Diet, that will make you sick. Very bad idea, don't do it, I don't recommend it.
    3. What I did:
    Read the book, "Art and Science of Low Carbohydrate Eating" and Dr Bernstein's book, " Diabetes Solution". Both were in my local library.
    4. MY RESULT: Stayed on a Keto diet for 18 months. Lost 72 pounds without counting calories. BLood glucose numbers returned to normal. Have had normal range a1c's for last 6.5 years eating 50-70 grams of carb a day. 50-70 grams a day of carb does not put me into the Keto range.
    5. Last Visit with the ENDO who told me KETO was a bad idea:
    Saw my Endocrinologist this past Monday. She praised me highly for another A1c in the normal range and fasting blood glucose test in normal range. She says she does not consider me to have diabetes any longer and writes in my chart each time I see her: No clinical evidence of diabetic disease
    I have Keto test strips but only use them when I am ill to check to see if I have ketones and need to go to urgent illness for rehydration and anti nausea medication
    Different people get to the stage of having ketones at different levels of low carb eating. It depends on your body size, activity level,and possibly other medical conditions. Most women will not be in the Keto range at 50 plus grams of carb. Most people will be in Keto range if they eat a total of 20-30 grams of carb a day. It takes a few days to maybe a week of eating very low carb to attain Keto range.
    There are a number of closed Facebook groups you can join that are all about the Keto way of eating.
    More and more doctors and other medical professionals are coming around to using low carb including Keto diet as a recommendation for people with diabetes.
    There are and have been a number of poeple on this forum over the years that have done Keto or are doing Keto.

  3. maryd98

    I've read quite a few posts here from different people who've either tried a keto diet or who follow it regularly. I've never done it myself, but it seems to work for some people.
    Personally, I feel like the more 'balanced' I can make my meals/snacks, the more I'm able to stick with the plan over the long haul. I don't like the idea of cutting out any food group --or even any particular foods--except the ones I don't like! I do avoid dairy, because I'm lactose intolerant, but I have things like soy milk and vegan/veggie/nut cheese. If I have regular dairy, I get sick, so it's easy to cut that out.
    I focus on my BG trends and patterns more than on specific numbers on specific days. I do not try to maintain non-diabetic BG numbers 100% of the time. Still, the goals I've set are attainable and have kept me in good health; after living with T2 diabetes for 18+ years, I manage it without meds and have no signs of compications (knock on wood!).
    We each have to find our own way to live with diabetes and manage it so that we avoid complications. I would not advise anyone to follow a ketogenic diet, but like I said, I have read of people who do follow it, and they seem to be happy with it. I've read some negative comments, too, by some who've tried it. There's no single plan that works for everyone with T2 diabetes.
    I wish you good luck and good health as you continue on your journey!

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What is renal tubular acidosis (RTA)? RTA is a type of metabolic acidosis caused by the kidneys failure to properly acidify the urine. Find more videos at http://osms.it/more. Study better with Osmosis Prime. Retain more of what youre learning, gain a deeper understanding of key concepts, and feel more prepared for your courses and exams. Sign up for a free trial at http://osms.it/more. Subscribe to our Youtube channel at http://osms.it/subscribe. Get early access to our upcoming video releases, practice questions, giveaways and more when you follow us on social: Facebook: http://osms.it/facebook Twitter: http://osms.it/twitter Instagram: http://osms.it/instagram Thank you to our Patreon supporters: Sumant Nanduri Omar Berrios Alex Wright Sabrina Wong Suzanne Peek Arfan Azam Mingli Fng Osmosis's Vision: Empowering the worlds caregivers with the best learning experience possible.

Metabolic Acidosis Treatment & Management: Approach Considerations, Type 1 Renal Tubular Acidosis, Type 2 Renal Tubular Acidosis

Metabolic AcidosisTreatment & Management Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN more... Treatment of acute metabolic acidosis by alkali therapy is usually indicated to raise and maintain the plasma pH to greater than 7.20. In the following two circumstances this is particularly important. When the serum pH is below 7.20, a continued fall in the serum HCO3- level may result in a significant drop in pH. This is especially true when the PCO2 is close to the lower limit of compensation, which in an otherwise healthy young individual is approximately 15 mm Hg. With increasing age and other complicating illnesses, the limit of compensation is likely to be less. A further small drop in HCO3- at this point thus is not matched by a corresponding fall in PaCO2, and rapid decompensation can occur. For example, in a patient with metabolic acidosis with a serum HCO3- level of 9 mEq/L and a maximally compensated PCO2 of 20 mm Hg, a drop in the serum HCO3- level to 7 mEq/L results in a change in pH from 7.28 to 7.16. A second situation in which HCO3- correction should be considered is in well-compensated metabolic acidosis with impending respira Continue reading >>

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  1. kellymh

    I generally don't post too much on reddit because I was being continuously trolled, but I feel like so many women want to know about keto and pregnancy/breastfeeding, so I decided to share my story. It's long, so grab a snack :)
    So I was doing keto for several years before I got pregnant. Then the morning sickness hit and I couldn't handle it, even with a prescription for nausea medication (reglan). Around the 25 wk mark I felt much better and started keto again with no drama or problems. I found that restarting was mostly mind over matter. I was so afraid I was going to get sick eating meat again, but when I actually just ate it, I was fine. YMMV, but I would encourage you to try. I'm in the medical field, so I did a disgusting amount of research. The info is out there- what you eat during pregnancy has long term consequences for your baby. I'm not about mom shaming, but the internet seems to love telling pregnant women to eat whatever they want. I think this is insane. You should do your best, for your sake and your childs. And lets be honest- thats not consuming a pint of ice cream and a package of oreos. We know when we can do better. Do a little better at a time, and before you know it you'll be back to full keto. My heartburn and nausea got DRAMATICALLY better once I was back to keto. Now for the semi scary part- I did my screening for gestational diabetes around 28 wks (i think) and I failed it miserably! I read on here later that you are supposed to carb up for a few days before the test, but I didn't read that in time so I don't know if it would have helped. Anyway, I start seeing a perinatologist. I had already been tracking my blood sugar for a while before this, and it was PERFECT. Not a single value out of range. The nutritionist urged me to eat 150 carbs a day, but saw my numbers and said, along with my doctor, "You're one of our best patients. Just keep doing what you're doing!" haha! No problem, doc. I'm 5'2" and started pregnancy at 124 lbs, and when I delivered I was 139. I was eating about 1600 cal a day, and between 20-30 carbs. Interestingly enough, my perinatoligst worked on a research study in medical school that examined ketones in pregnancy. It's worth noting that he has contributed to several textbooks in the field. Basically the study found no danger, but was scrapped due to funding before it could be published. The state of nutrition research is sad! I was having high level ultrasounds pretty frequently and my baby boy was perfect. They said he would be smaller when he was born, but that was to be expected because I'm small. I was 6 lbs 3 oz, my mom was 6 lbs, and one of my aunts was 5 lbs 4 oz. The women in my family make small, healthy babies! On March 25th my son was born weighing 5lbs 6oz. Luckily I don't worry about percentiles and all that crap, because he was in like the 3rd percentile for weight. NO ONE was worried, not my doctor, not his pediatrician, or anything. He's been exclusively breastfed from day 1. I stopped tracking my food so closely because newborn life is exhausting. I stuck to the same stuff I ate while I was pregnant. I've lost 10 of the 15 lbs I gained. I plan on starting to track again soon. Here's the coolest part to me- at his 4 wk pediatrician visit, my son weighed 8 lbs!!! The pediatrician was amazed he'd only had breastmilk. She said "Really?! He hasn't had any formula at all?!" Nope! He's 6 wks now and has the most adorable double chin :) I can't speak to what would happen about suddenly starting keto while breastfeeding, but I only did it for 10 wks before he was born, and I've obviously had no supply issues because he is growing like a weed! In fact, while pregnant I entered a diet contest on ketodietapp.com, and won second place! Here is the link for my story: http://ketodietapp.com/Blog/post/2016/02/21/results-of-the-30-day-january-ketodiet-challenge
    Anyway, thats my story! I know this sub isn't super active, and I think its because the internet seems to really discourage women from doing low carb. All the "big" breastfeeding websites really demonize it, see La Leche League and KellyMom. I am friends with a LLL leader, and she said she's had many moms do low carb and BF, and that the problem isn't so much the drop in carbs as the drop in calories. It seems the best way to start keto may be to just track what you normally would eat for a few days to get a baseline calorie number, and then maybe decrease gradually?! I hope all this was helpful for someone :)
    **oh yeah, I had a normal vaginal delivery, and recovery was a breeze. I had no problems pooping or anything, in pregnancy or after.

  2. ketolaura

    Quick question: why do you need to carb up before the test?
    I am 13 weeks pregnant and I am hoping to go low carb soon. I gained 2 pounds in the last month (eating anything and everything) and according to the ultrasound the baby is normal and doing great. But I want him/her to have good eating habits. I hope to set a good example.
    I'm happy your pregnancy went well.

  3. rickamore

    Quick question: why do you need to carb up before the test?
    Due to Physiological insulin resistance you'll test a false positive for glucose intolerance as your BG skyrockets from 75g of glucose. Eating 150~g of carbs/day for three days before the test is enough to reverse it and test normally on the glucose test.
    If you plan to stay keto the whole time, you'd be better off testing BG yourself for several days or seeing if they will test a1c.

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This is another in my how to series of making things. In this video I show you how to make a water ionization alkalization water unit using simple parts found around the house for around $20 to $30. I did this unit for my health, and to help me clean up 48 years of too many burgers and pizza, also to help me clean the fluoride and chlorine that many cities are putting into the public drinking water systems. I have been drinking the water I made in this unit for over a few weeks, with no harmful effects what so ever, I have however felt better, have more energy, and just a few days. After I started drinking my water I was able to cut my grass and still felt fine, where before I was dead, heck at one point I had to lay in my driveway to rest before I could get cleaned up. This video is intended for educational purposes only. So if you do decide to build one please do so at your own risk. The water made in this unit will result in a high PH ionized alkalized water which is said to balance the high acidic levels of your body. Note to date I do not own a digital ORP or PH level meter so I did the best I could with a chemical test unit I own. I advise anybody building one to purchase these items to get an accurate result of your water levels. Ok Ed, but what does PH and ORP mean? In simple terms PH = acid/alkaline balance = ionizing = O.R.P. (oxidation reduction potential) This is saying that when there are more H+ ions in water than OH- ions, it will read as acidic. When there are more OH- than H+, it's alkaline water. So acid or alkaline liquid is measured as pH, and pH is a measure of hydrogen ions (atoms).The more H+ in a liquid, the more 'acidic'. The more OH-, the more alkaline. What is a good level then? The fact is, most water ionizers will have an ORP reading of -300 to -600 at the 9.5 pH level most often used for drinking, but I have read that the body is not able to process anything over -350, and as the ORP goes to a stronger negative reading than -350 the body isn't able to process the excess. Drinking ionized water throughout the day, at any negative ORP level, gives the body a steady supply of antioxidants -- and minerals -- and hydration, so do not freak out if your water is at a -500 ORP. What is the reason then for drinking alkaline water? Some are reverse aging, more energy, there are too many to list, but the answer is out there on the internet please do the research. Lets just say our body is overloaded with acid type foods like burgers, beer, and soda, it needs help or it starts to rob bones and teeth, and yes, we actually erode our own skeleton to feed our acid habit. It can lead to gout which is painful I'll tell you what. Alkaline water helps to reduce the acid and help the body to balance, but reducing the burgers and beer should be the first step. Remember blood is 7.35 to 7.45 PH.

Efficient Extra- And Intracellular Alkalinization Improves Cardiovascular Functions In Severe Lactic Acidosis Induced By Hemorrhagic Shock | Anesthesiology | Asa Publications

Efficient Extra- and Intracellular Alkalinization Improves Cardiovascular Functions in Severe Lactic Acidosis Induced by Hemorrhagic Shock From the CHU Nancy, Service de Ranimation Mdicale Brabois, Pole Cardiovasculaire et Ranimation Mdicale, Hpital Brabois, Vandoeuvre les Nancy, France; Institut National de la Sant Et de la Recherche Mdicale (INSERM) U1116, Equipe 2, Facult de Mdecine, Vandoeuvre les Nancy, France; Universit de Lorraine, Nancy, France (A.K., N.D., and B.L.); INSERM U1116, Equipe 2, Facult de Mdecine, Vandoeuvre les Nancy, France; Universit de Lorraine, Nancy, France (N.S., K.I., and C.S.); and Critallographie, Rsonnance Magntique et Modlisation (CRM2), Unit Mdicale de Recherche (UMR), Centre National de la Recherche Scientifique (CNRS), Institut Jean Barriol, Facult des Sciences et Technologies, Vandoeuvre les Nancy, France; Universit de Lorraine, Nancy, France (J.-M.E. and S.L.). From the CHU Nancy, Service de Ranimation Mdicale Brabois, Pole Cardiovasculaire et Ranimation Mdicale, Hpital Brabois, Vandoeuvre les Nancy, France; Institut National de la Sant Et de la Recherche Mdicale (INSERM) U1116, Equipe 2, Facult de Mdecine, Vandoeuvre les Nancy, France; Univer Continue reading >>

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  1. Christian

    I read conflicting views about whether or not the human body can create glucose out of fat. Can it?

  2. David

    Only about 5–6% of triglyceride (fat) can be converted to glucose in humans.
    This is because triglyceride is made up of one 3-carbon glycerol molecule and three 16- or 18-carbon fatty acids. The glycerol (3/51-to-57 = 5.2–5.9%) can be converted to glucose in the liver by gluconeogenesis (after conversion to dihydroxyacetone phosphate).
    The fatty acid chains, however, are oxidized to acetyl-CoA, which cannot be converted to glucose in humans. Acetyl-CoA is a source of ATP when oxidized in the tricarboxylic acid cycle, but the carbon goes to carbon dioxide. (The molecule of oxaloacetate produced in the cycle only balances the one acetyl-CoA condenses with to enter the cycle, and so cannot be tapped off to gluconeogenesis.)
    So triglyceride is a poor source of glucose in starvation, and that is not its primary function. Some Acetyl-CoA is converted to ketone bodies (acetoacetate and β-hydroxybutyrate) in starvation, which can replace part — but not all — of the brain’s requirement for glucose.
    Plants and some bacteria can convert fatty acids to glucose because they possess the glyoxylate shunt enzymes that allow two molecules of Acetyl-CoA to be converted into malate and then oxaloacetate. This is generally lacking in mammals, although it has been reported in hibernating animals (thanks to @Roland for the last piece of info).

  3. blu potatos

    To be more detailed it is the irreversibly of the reaction carried by Pyruvate dehydrogenase that makes the conversion of the fatty acid chains to glucose impossible. The fatty acids chains are converted to acetyl-CoA.
    Acetyl-CoA to be converted into pyruvate need an enzyme that can do the Pyruvate Dehydrogenase's inverse reaction (in humans there is no such enzyme). Than the pyruvete inside the mitochondria is converted into glucose(gluconeogenesis).

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