Starvation Acidosis

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Renal Fellow Network: Starvation Ketosis: A Rare Cause Of Metabolic Acidosis

Starvation Ketosis: A Rare Cause of Metabolic Acidosis Asa child growing up in India, I have seen several family members performingritual fasting. Fasting is aubiquitous religio-cultural practice that is found, in varying forms, acrossthe world. The month-long Ramadan and Buddhist Lent fasts are examples ofreligious observances practiced by followers of Islam, and Buddhism,respectively. These fasts are characterized by a documented impact on metabolic health , which can be minimized by well-known management strategies .The practice of fastingis a major part of Hinduism and can range from light restriction toextreme abstention. Mahatma Gandhi was a fervent supporter of fasting byreligious convictionand as a way of freeingoneself of theconstraints of the body. He used fasting as a means of exerting politicalpressure and engaged in several hungerstrikesto protest withnon-violence. Inthe western countries, starvation ketosis or ketoacidosis has been reported inindividuals with strict dieting (e.g. carb-restricted, ketogenic diets or Atkins diet), extreme exercise, andrarely with malnutrition. Few cases of starvation-induced ketoacidosis during pregnancy and lactation , and during the Continue reading >>

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  1. Aaron1963

    High Blood Pressure Caused by Ketogenic Diet and/or Coconut Oil?

    I always had high blood pressure since first checking it when I was in high school. Finally last month I was experiencing some dizziness, etc. at times, and on my doctor's visit my blood pressure was quite low. My doctor told me to buy a home blood pressure meter and self adjust my medication, which I did to the point of not taking any, and my blood pressure has remained on the low end of normal. That is until a couple of days ago. It's now suddenly gone up to the 140/90 range for no apparent reason and I started back on my blood pressure medication this morning. The only thing I can think of that's changed is I believe I've recently entered deep ketosis, and I've been taking a couple spoonfuls of coconut oil with my coffee each day, in addition to the normal HWC. My total fats have also gone up recently, but I haven't added any new ingredients to my menu other than the coconut oil. I've been doing fasts for the past month, and just did one two days ago, but don't think that should have affected anything, and my blood pressure actually started going up before I started the fast. In reading on the internet, seems fasting should if anything decrease blood pressure. I did see a couple comments on the internet about coconut oil maybe increasing blood pressure.
    Anyone else experience any increase in blood pressure due to coconut oil and/or ketosis?

  2. AnnC

    Well, I lost a lot of weight as a result of going LCHF/ketogenic, and I was able to halve and then stop my BP medication, which I'd been on for about 15 years. I don't test all that often any more, but when I do, I'm still around 105/70.

  3. Nicoletti

    Originally Posted by Aaron1963
    I always had high blood pressure since first checking it when I was in high school. Finally last month I was experiencing some dizziness, etc. at times, and on my doctor's visit my blood pressure was quite low. My doctor told me to buy a home blood pressure meter and self adjust my medication, which I did to the point of not taking any, and my blood pressure has remained on the low end of normal. That is until a couple of days ago. It's now suddenly gone up to the 140/90 range for no apparent reason and I started back on my blood pressure medication this morning.
    Anyone else experience any increase in blood pressure due to coconut oil and/or ketosis? No. Never heard of coconut oil or ketosis increasing blood pressure. What concerns me about yours is the second number.
    What medication did you self-adjust? Didn't see any meds in your signature.

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In this video I discuss what is stress, why is stress bad, and what causes stress. I also cover how stress is bad, how to deal with stress, and stress management. Transcript What is stress? Whats up dudes, and whats up ladies, Bryan here and in this video we are going to look at stress. What is it, what causes it, and what can we do about it? So, Lets roll. Stress hormones Stress is your body's way of reacting to any kind of demand or threat. When the body feels stress, your hypothalamus, a tiny region in your brain, signals your adrenal glands, located atop your kidneys, to release a surge of hormones, which include adrenaline and cortisol, into the bloodstream. As these hormones are released, the liver is triggered to produce more blood sugar, which gives you an energy kick, breathing becomes more rapid, and heart beat and blood pressure rise. If the stress is caused by physical danger, these chemicals can be beneficial, as they give you more energy and strength, and also speed up your reaction time and enhance your focus. But, if the stress is caused by something emotional, it can be harmful, because there is no outlet for this extra energy and strength. Once the source of the stress has passed, hormone levels return to normal as do heart rate and blood pressure, and other systems also return to normal. Recent stress statistics show the top 7 causes of stress in the US to be job pressure, relationships, money, health related, poor nutrition, media overload, and sleep issues. All of these are of the emotional kind, not the physical danger kind that can be beneficial. 77% of people REGULARLY experience PHYSICAL symptoms caused by stress, 54% of people say stress has caused them to fight with people close to them, and 30% of people say they are always or often under stress at work…wow! So, how does all of this stress effect our bodies? Long term activation of the stress-response system can cause major problems including… • Anxiety • Depression • Digestive problems • Headaches • Heart disease • Sleep problems • Weight gain • Memory and concentration impairment It is vital to learn how to deal with stressors in your life. Some things you can do to manage stress include… Getting regular exercise, which can act as a distraction and also causes the release of endorphins that boost your mood. Eat a healthy diet that includes fruits and vegetables which provide vitamins, minerals and antioxidants that can help maintain proper bodily functions. Make consistent time in your schedule for relaxation and fun, such as going to a yoga class, listening to music, take a walk or work in your garden. Build relationships and friendships with people who have more positive attitudes. Cut down on caffeine, sugar, energy drinks, and alcohol. The effects of these are only short term. Make sure you get enough good quality sleep. If all else fails, seek professional help. Bottom line. As you can see by the statistics, stress is a huge problem in society. A big part of being healthy is being happy. If stress is a big problem in your life, do something about it now, don’t let it erode your health. Other sources... http://www.medicalnewstoday.com/artic... http://www.webmd.com/balance/stress-m... http://www.statisticbrain.com/stress-...

Severe Acidosis Caused By Starvation And Stress.

Severe acidosis caused by starvation and stress. Department of Pediatrics, Children's Hospital of Wisconsin, Milwauke, WI, USA. A 1-year-old boy had severe anoxic brain injury owing to a cardiorespiratory arrest. He had an initial metabolic acidosis, but this largely resolved by hospital day 2. He then had a persistent, profound metabolic acidosis. Evaluation on hospital day 6 found that the patient had ketonemia, ketonuria, and a normal serum glucose level; he had received no intravenous dextrose during his hospitalization. The dextrose-free fluids were given initially to protect his brain from the deleterious effects of hyperglycemia after brain injury. Continuation beyond 24 hours was inadvertent. The initiation of dextrose-containing intravenous fluids produced a rapid resolution of his metabolic acidosis. Starvation usually produces a mild metabolic acidosis, but when combined with physiologic stress, starvation may cause a severe metabolic acidosis. Among the few reports of severe starvation ketoacidosis, our case is unique because the patient was monitored closely in an intensive care unit, allowing us to describe the time course of the acidosis in detail. Continue reading >>

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  1. JeiCR

    I am sad to discover that I must stop doing 5:2 intermittent fasting because it appears to have caused my blood pressure to become uncontrollably high. I had lost 10 pounds (4.5 kg) over the course of 12 weeks, which I was very happy about. I found the program to be very easy, and the hunger pangs not that difficult to endure, and was enjoying the results of the program so much that I did not want to believe that my steadily rising blood pressure could be caused by 5:2. I am a 53 year old female who has been controlling my tendency toward high blood pressure through weight loss, diet, and exercise. My BMI was on the upper half of the healthy range when I started the fast diet, but I wanted to start training to run a 5k, and thought it would be helpful to first lose some unnecessary weight I was carrying. My goal was to lose 15 pounds (6.8 kg)…still keeping my BMI within the healthy range. I was, fortunately, keeping an eye on my BP with my home blood pressure monitor, had I not been monitoring it, I would not have known it had reached over 180/100! For the first time in my life I had to go on blood pressure medication! Even then, the medication still was not keeping it under control. My husband pointed out that the only change I had made was the 5:2 diet, so I reluctantly stopped, and after about a week my blood pressure returned to normal, and is still normal now, after two weeks. I am very relieved, as it was quite scary to have it so out of control, but at the same time I am disappointed because the Fast Diet had been such an easy way for me to lose weight. I still have 5(2.3 kg) pounds to go, and at least want maintain the weight I have lost, so I need to figure out a plan that doesn’t involve fasting. I don’t know for certain why 5:2 was apparently raising my BP, but it vaguely felt as if the level of stress hormones in my body kept rising over time the longer I was on the diet, my pulse had also been higher than normal. I am wondering if anyone else has experienced this problem?

  2. char6

    Hi, JeiCR. I am a doctor, and that really does sound strange! Do you think extra sodium could have been sneaking into your diet, such as in soups? Or a lot of extra caffeine? Were you taking a decongestant medication, by any chance, or any weight loss supplements that could contain stimulants? Are your ankles swelling a lot, in which case you would need to get your kidneys checked? (I know you said nothing else had changed, but just checking.)
    What is your current BMI? Could it be that you are stressing your body by trying to force it too low (although I don’t think I have ever heard of such a thing)?
    If your BMI is well within the normal range, maybe you could maintain your loss just by training for the 5K, or by fasting only 6:1.

  3. SAMM

    I don’t have a medical opinion.
    Im wondering about wether you were close to your TDEE on non fasting days. Also curious as to the foods on fasting days and feeding days.
    The only thing I can think of is your protein intake may need to be spread out.
    Again not advice I understand having 25g 25g 25g of protein on feed days has an effect on the vascular system. Is the new standard.
    This points to the type of protein intake I use on fasting days. I use non flavored whey protein as it is said in general to metabolize quicker for the the body to use. On fasting days I aim for 10g 10g 10g when planning my menu.
    On another note if what’s happening to you was happening to me. I would make sure to get a Flu shot. Reason is typically having the flu increases inflammation. There is a greater percentage of heart attacks occurring when having the flu. Avoiding 30 flu strains over ten years lowers to exposer to the inflamation caused by flu. Your 50% less likely over ten years to have heart attack. So wether it’s 5:2 or losing weight in any other way cholesterol lvl may raise when fat is released for energy. So there could be a combination of conditions to keep watch over. Inflamatory foods, flu inflammation, elevated blood pressure. So If it were me I would be more sedentary on fasting days, but eating anti inflammatory foods on feed day especially.
    Here’s a link to a list of the most anti inflammatory foods and their nutrition data.
    Again I can’t be more clear about the fact that I can’t give any medical advice whatsoever. I’m not qualified at all. I do however have an opion that what is on my fork is just as important to consider as medication. Especially when were prone to health issues.
    I’ll make a huge guess and wild assumption. If I eat a fry up , of greasy greasy greasy ,bacon,sausage,burger,BBQ. Just as poor fat as possible, and flood my blood with fat. I may also influence the level of fat in my blood by eating lower fat protein such as whey protein.
    I go as far to boil my chicken breast in water and skim off the fat before I put it in my chicken soup when I have the flu.
    The biggest change I’ve made since watching The Truth About Exercise. Is to do better on my N.E.A.T, trying to also become healthy enough to accomplish H.I .T.T. So I can do it regularly. My experience trying this has made me more conscious about my meals , how to enjoy what’s good for me even more that what’s bad.
    Best wishes hope to see you around for five more decades.

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A review of the differential diagnosis of an elevated anion gap metabolic acidosis, focusing predominantly on lactic acid, ketoacids, and toxic alcohols (i.e. methanol, ethylene glycol, and propylene glycol). Also includes discussion of renal failure, oxoproline, toluene, and paraldeyhyde. Use of the VA and Stanford name/logos is only to indicate my academic affiliation, and neither implies endorsement nor ownership of the included material.

Starvation Ketoacidosis: A Cause Of Severe Anion Gap Metabolic Acidosis In Pregnancy

Abstract Pregnancy is a diabetogenic state characterized by relative insulin resistance, enhanced lipolysis, elevated free fatty acids and increased ketogenesis. In this setting, short period of starvation can precipitate ketoacidosis. This sequence of events is recognized as "accelerated starvation." Metabolic acidosis during pregnancy may have adverse impact on fetal neural development including impaired intelligence and fetal demise. Short periods of starvation during pregnancy may present as severe anion gap metabolic acidosis (AGMA). We present a 41-year-old female in her 32nd week of pregnancy, admitted with severe AGMA with pH 7.16, anion gap 31, and bicarbonate of 5 mg/dL with normal lactate levels. She was intubated and accepted to medical intensive care unit. Urine and serum acetone were positive. Evaluation for all causes of AGMA was negative. The diagnosis of starvation ketoacidosis was established in absence of other causes of AGMA. Intravenous fluids, dextrose, thiamine, and folic acid were administered with resolution of acidosis, early extubation, and subsequent normal delivery of a healthy baby at full term. Rapid reversal of acidosis and favorable outcome are achi Continue reading >>

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  1. wallflowerwendy

    Hey so every time I go into Ketosis, I get UTI-like symptoms until I start eating carbs again. When I first started doing keto diets I actually thought I had a UTI so I went to the doctor and tested negative which confused me. It kept happening every time and I JUST now put 2 and 2 together. Does anyone else have the same problem? If so, does anyone have any tips on how to stop it so I can keep going with this?
    For reference, when I do keto I go super low cal and basically only consume the necessary protein for someone my size--almost negligible fat/carbs. I can see the fat on my body getting less and less every day so I really want to be able to keep this up for longer.

  2. Anniel

    What UTI symptoms do you get? When you first go into ketosis you will lose a lot of water weight and will pee a lot and may go through what is called keto flu. This is temporary and goes away within a couple of days as long as you stay in ketosis.

  3. wallflowerwendy

    Anniel, on 15 Mar 2017 - 11:10 AM, said:

    What UTI symptoms do you get? When you first go into ketosis you will lose a lot of water weight and will pee a lot and may go through what is called keto flu. This is temporary and goes away within a couple of days as long as you stay in ketosis.
    I'be already been through keto flu. It burns to pee and I continue to pee an excessive amount every single time I do keto. This has happened 6 times so far this last year (kept track of painful cloudy peeing, never cross referenced it with my food consumption until now). Some people online have these symptoms after a couple week of keto, but I get it immediately?

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