By-products formed when the body breaks down fat for energy. When the body is starved of glucose or, as in the case of Type 1 diabetes, does not have enough insulin to use the glucose that is in the bloodstream, it begins breaking down fat reserves for energy. Unlike glucose, which “burns clean,” the breakdown of fat creates potentially toxic by-products called ketones, which accumulate in the blood. An excessive amount of ketones in the blood is called ketosis. When the kidneys filter ketones into the urine, the condition is called ketonuria and can be detected by urine ketone tests. If enough ketones accumulate in the blood, they can cause a potentially life-threatening chemical imbalance known as ketoacidosis. The symptoms of ketoacidosis include nausea, vomiting, tiredness, frequent urination, and a fruity odor to the breath. Anyone with symptoms of ketoacidosis should seek medical help immediately. Ketoacidosis is often what causes people to first be diagnosed with Type 1 diabetes: Beta cells in the pancreas stop making enough insulin, thus preventing body cells from getting energy in the form of glucose. The body responds by burning fats for fuel, creating an excess of ketones in the blood. As dehydration also sets in, the person develops ketoacidosis. The nausea and vomiting that accompany ketoacidosis are sometimes mistaken for the symptoms of a bad flu. People with diabetes, particularly those with Type 1 diabetes, are at increased risk of ketoacidosis when they are sick. The stress of illness tends to raise blood glucose levels. But since illness often decreases a person’s appetite, resulting in less food intake than usual, some people mistakenly decrease their insulin dosages. In fact, increased amounts of insulin are often needed when a person is sick. Continue reading >>
10 Things Your Pee Can Tell You About Your Body: Taking A Deep Dive Into Urinalysis, Dehydration, Ketosis, Ph & More!
See, for the past several days, I’ve been randomly grabbing drinking glasses from the shelf in the kitchen… …and peeing into them. And yes, I realize that now you will likely never want to join me at my home for a dinner party. So why the heck am I urinating into our family’s kitchenware? It’s all about better living through science and figuring out ways to live longer and feel better (at least that’s what I tell my wife to appease her). It’s also about my sheer curiosity and desire to delve into an N=1 experiment in self-quantification with urinalysis. It’s also because I’ve been too lazy to order one of those special urinalysis specimen cups with the cute plastic lid. And let’s face it: with my relatively frequent use of a three day gut testing panel, my wife is already somewhat accustomed to giant Fed-Ex bags full of poop tubes sitting in the fridge, so urine can’t be all that bad, right? Anyways, in this article, you’re going to learn exactly why I think it’s a good idea to occasionally study one’s own urine, and you’ll also discover 10 very interesting things your pee can tell you about your body. Enjoy, and as usual, leave your questions, thoughts, feedback, and stories of your own adventures in urinalysis below this post. ———————– The History Of My Interest In Urinalysis Two years ago, I first became interested in urinalysis when I discovered a new start-up called “uChek”. The premise of uChek was quite simple. People with diabetes who want to check the amount of glucose in their urine would simply be able to download uChek to their iPhone or iPad. Then, after a “mid-stream collection,” (yes, that’s exactly what it sounds like and, in my experience, despite my Private Gym training, can be quite difficult to 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 >>
Lupus And Kidney Disease: What You Should Know About Lupus Nephritis (lupus Kidney Disease)
Adapted from a presentation at the SLE Workshop at Hospital for Special Surgery Introduction At this session of the SLE Workshop at HSS, Dr. Kyriakos Kirou presented his expertise on the diagnosis, symptoms, treatments, and research related to lupus and kidney involvement, including lupus nephritis (LN). Dr. Kirou is an assistant attending physician at HSS and the co-director of the Mary Kirkland Center for Lupus Care. When presenting, Dr. Kirou emphasized that the purpose of his presentation is to educate patients about lupus and its interaction with the kidney and should not be used as therapeutic advice. He stressed that when patients need to make a decision about their own specific care, they should consult their own rheumatologist. It is important to recognize that there’s no “one fits all” therapy. Dr. Kirou discussed how lupus can affect the kidney and cause the disease known as lupus nephritis (LN). He also discussed tests that are used for diagnosis, as well as available therapies. He also spoke about the necessary lifestyle changes that LN patients may have to adopt after their diagnosis of LN to minimize harm in their bodies. First, it is important to understand how the kidney functions, what happens when someone with lupus has problems with their kidneys, and how they can go about dealing with the situation. Background Information Lupus:Lupus is a chronic and autoimmune disease that affects several parts of the body, including joints, blood, skin, and kidneys. The immune system of those with lupus does not function properly. Lupus creates autoantibodies that fight and damage the cells, tissues, and body organs. When they are present, they can likely lead to disease. Kidney: The kidney is a bean-shaped, fist-sized organ that helps cleans the body from a Continue reading >>
Kidneys And Ketones.
When you shuffle thorough various low carb or nutrition blogs, you can't help but feel the splash of a new low carb diet study. Especially when media generate headlines such as "Low carb, high fat diet could replace dialysis." While it would have been prudent for MSNBC to clarify that this may end up only applying to mice, the results are still news worthy. The work was conducted by researchers at the Mount Sinai School of Medicine in New York, NY. They investigated the effect of diet, specifically a ketogenic diet, on nephropathy in diabetic mouse models. To many people, this may seem to be a paradoxical diet to study in diabetics - perhaps ketoacidosis comes to mind - but it looks to have potential. Nephropathy refers to damage of the kidneys and is a known complication of diabetes. Prior to the advent of insulin therapy, type 1 diabetes (absence of insulin) caused a very short life expectancy. However, as insulin allowed type 1 diabetics to live much longer lives, and as more and more people are becoming type 2 diabetics (insulin resistant), these individuals are living with long-term exposures to relatively high blood sugar. Fortunately, the standard of care is to maintain blood glucose as near normal as possible, which has been shown to reduce - although not eliminate - complications of hyperglycemia. These researchers had a hunch that there could me an additional strategy for reducing complications, and perhaps even reversing it. While working on other experiments, the researchers noted that ketones produced a molecular action that could benefit diabetic patients. They also demonstrated that ketones directly reduce the oxidative damage induced by bathing neurons in a glucose solution. Given that the ketogenic diet shifts cell metabolism away from glucose utilizati Continue reading >>
Breaking Down Your Urinalysis
Contents: Introduction Conclusion Introduction If you’re a lupus patient, I’m sure at some point you’ve heard those wonderful words “…now, go pee in this cup.” Unfortunately, holding your morning pee while trying to aim into the miniature size sterile Dixie® cup is the easy part. What is not so easy to understand is the medical jargon that follows when you get the results of your urinalysis. Doctors causally throw out words like ketones and you think, “What, my pee is musical?” Or leukocytes and you go, “Isn’t that some sort of dinosaur fossil? Or creatinine and you ponder, “Are you speaking Latin?” These are just some of the many medical terms that often leave lupus patients scratching their already itchy heads (thanks alopecia) and wondering what on earth is going on? So why don’t we delve a little deeper….into the toilet. Let’s translate what your pee really says about you. Sometimes, doctors don’t have the time to explain the complicated medical jargon – which isn’t very helpful. So how about the CliffsNotes® version? Let’s get down to it, and trust me, urine for a real treat. Sorry I just couldn’t hold that in! Back to top The Basics DEFINITION A urinalysis is the physical, chemical, and microscopic examination of your pee. It involves a slew of different tests to measure various compounds and detect the stuff that pass through the urine. WHY PEE IN A CUP? Urinalyses are done as part of a medical exam to look for signs of disease. If you have signs of kidney disease or nephritis, your doctor will most likely have you perform tests on a regular basis. Sometimes urinalyses are used to detect acute conditions like urinary tract or kidney infections. In a nutshell, your kidneys take out the trash. They filter waste material, fl Continue reading >>
Tweet Ketosis is a state the body may find itself in either as a result of raised blood glucose levels or as a part of low carb dieting. Low levels of ketosis is perfectly normal. However, high levels of ketosis in the short term can be serious and the long term effects of regular moderate ketosis are only partially known at the moment. What is ketosis? Ketosis is a state the body goes into if it needs to break down body fat for energy. The state is marked by raised levels of ketones in the blood which can be used by the body as fuel. Ketones which are not used for fuel are excreted out of the body via the kidneys and the urine. Is ketosis the same as ketoacidosis? There is often confusion as to the difference between ketosis and ketoacidosis. Ketosis is the state whereby the body is producing ketones. In ketosis, the level of ketones in the blood can be anything between normal to very high. Diabetic ketoacidosis, also known as DKA, only describes the state in which the level of ketones is either high or very high. In ketoacidosis, the amount of ketones in the blood is sufficient to turn the blood acidic, which is a dangerous medical state. When does ketosis occur? Ketosis will take place when the body needs energy and there is not sufficient glucose available for the body. This can typically happen when the body is lacking insulin and blood glucose levels become high. Other causes can be the result of being on a low carb diet. A low level of carbohydrate will lead to low levels of insulin, and therefore the body will produce ketones which do not rely on insulin to get into and fuel the body’s cells. A further cause of ketosis, less relevant to people with diabetes, is a result of excessive alcohol consumption. Is ketosis dangerous? The NHS describes ketosis as a pote Continue reading >>
Caution: Don’t Get Caught With Ketones
Ketoacidosis is an extremely serious diabetic complication that can lead to coma and even death. Unfortunately it is also fairly common. The good news, however, is that with proper care and an eye towards prevention, this costly and dangerous complication can be avoided. What Is Ketoacidosis? When there isn't enough insulin present for the metabolism of glucose, or when insufficient food has been eaten to satisfy energy requirements, the body burns fat for energy. Ketones are toxic, acidic byproducts of this process. Ketones are normally processed by the kidneys and excreted in the urine. But when more ketones are produced than the kidneys can handle, they can build up in the blood and lead to a dangerous condition known as diabetic ketoacidosis (DKA). Ketoacidosis raises the acidity of the body, which leads to "a cascade of problems throwing off a number a parameters in the body," says Cindy Onufer, RN, MA, CDE, the diabetes research and clinical care coordinator at Oregon Health Sciences University. Ketoacidosis rarely occurs in people with type 2 diabetes, who usually do not suffer from insufficiency of insulin, but is of great concern to those with type 1 diabetes. In fact, ketoacidosis is the number one cause of hospitalization for children with known diabetes in the United States. However, these hospitalizations are completely preventable if a urine ketone test is done and a care provider is called when indicated, says H. Peter Chase, MD, with the Barbara Davis Center for Childhood Diabetes in Denver, Colorado. Timely testing and prevention are of utmost importance as the condition can cause coma and death if proper treatment is not administered quickly. Higher ketone levels are a warning sign that your diabetes is out of control or that you may be in danger of ke 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 >>
Low Carb Dieting Myths
The myths about low carb dieting and specifically ketogenic diets abound in the American collective consciousness. These are just a few of the most pervasive myths I've encountered, with explanations as to why they are incorrect and simply don't make sense, scientifically: Myth 1: Carbs are an essential nutrient for good health. Some nutrition professionals still believe that carbohydrates are necessary to provide glucose to fuel the brain and avoid hypoglycemia. It's an old way of thinking, and it's just not true scientifically. Essential nutrients are nutrients which your body cannot make, so they have to be obtained on a daily basis from your food sources. There are essential proteins, and essential fatty acids, but there is no such thing as an essential carbohydrate. When the body is in ketosis, it has a “glucose sparing” effect. First, the skeletal muscles burn fatty acids preferentially which spares glucose for the brain to use. Second, once a person is keto-adapted, the brain switches to using ketone bodies for over half of the fuel it needs, and less glucose is needed since ketone bodies are being used as an alternative fuel. This small amount of carbohydrate (glucose or blood sugar) needed to fuel the brain during keto adaptation can be generated internally. Your liver can make all the glucose needed for brain function from glycogen stored in the liver. And if need be, the body can also make glucose from the protein in your food. Hence, carbohydrates are NOT essential nutrients, and many people, such as the Inuit of Alaska and the Masai of Africa live without them for long periods of time without any effect on health and well-being. The “brain needs carbs” idea is only true if you consistently eat a high carb diet (as most registered dietitians will tel Continue reading >>
Diabetes With Ketone Bodies In Dogs
Studies show that female dogs (particularly non-spayed) are more prone to DKA, as are older canines. Diabetic ketoacidosis is best classified through the presence of ketones that exist in the liver, which are directly correlated to the lack of insulin being produced in the body. This is a very serious complication, requiring immediate veterinary intervention. Although a number of dogs can be affected mildly, the majority are very ill. Some dogs will not recover despite treatment, and concurrent disease has been documented in 70% of canines diagnosed with DKA. Diabetes with ketone bodies is also described in veterinary terms as diabetic ketoacidosis or DKA. It is a severe complication of diabetes mellitus. Excess ketone bodies result in acidosis and electrolyte abnormalities, which can lead to a crisis situation for your dog. If left in an untreated state, this condition can and will be fatal. Some dogs who are suffering from diabetic ketoacidosis may present as systemically well. Others will show severe illness. Symptoms may be seen as listed below: Change in appetite (either increase or decrease) Increased thirst Frequent urination Vomiting Abdominal pain Mental dullness Coughing Fatigue or weakness Weight loss Sometimes sweet smelling breath is evident Slow, deep respiration. There may also be other symptoms present that accompany diseases that can trigger DKA, such as hypothyroidism or Cushing’s disease. While some dogs may live fairly normal lives with this condition before it is diagnosed, most canines who become sick will do so within a week of the start of the illness. There are four influences that can bring on DKA: Fasting Insulin deficiency as a result of unknown and untreated diabetes, or insulin deficiency due to an underlying disease that in turn exacerba Continue reading >>
Ketosis & Kidney Failure
Ketosis happens when your body resorts to fat for energy after your stored carbohydrates have been burned out. It often occurs when people fast and exercise. But most commonly, ketosis occurs in people who eat low-carb, high-protein diets, which are also called ketogenic diets. There’s some evidence that ketosis can tax your kidneys, leading to kidney stones and low blood pressure. In diabetics, a variant of ketosis can be fatal. However, a small but growing group of health professionals say ketosis is not the poison you’ve been lead to think it was, and it may be better for you than high-carbohydrate eating. Your specific dietary habits are best advised by your healthcare provider or nutritionist. Video of the Day Ketosis happens when you get a buildup of a substance known as ketones, or ketone bodies in your blood. They are released when your body’s carbohydrate stores run out and you have to break down fat stores for energy. Dieters tend to deliberately cause ketosis because it makes you feel less hungry. However, ketosis also makes you feel tired and sluggish, because as "Medical News Today" reports, ketones aren’t the most efficient source of energy, especially for your brain. Ketosis can also harm your kidneys. Annually, more than 100,000 people are diagnosed with kidney failure in the United States, reports the National Institute of Diabetes and Digestive and Kidney Diseases, or NIDDK. The condition is marked by the inability of your kidneys to do their job of eliminating wastes. One treatment for kidney failure is dialysis, a draining and lengthy artificial blood cleansing process. Another option is a kidney transplant. The NIDDK states that the cost of care for patients with kidney failure reached close to $32 billion in 2005. The federal government sub Continue reading >>
Why You Need To Stop Worrying About The Color Of Your Ketostix
Yeah, I know you like to use them, but there are so many misconceptions about what they are telling you, that I need to intervene and make sure you get it. But before I go there, let me urge you to just buy The Art and Science of Low Carbohydrate Living, and read pages 164-165. Phinney and Volek have the best description of this that has probably ever been written, and you should really just read it from them. If I could copy these pages verbatim and paste it here, I would. Seriously, it’s only a few bucks and it’s quite literally the book you want to own if you’re interested in low carb ketogenic diets. OK, while you wait for your book to arrive, let’s dig in… What ketostix measure First off, we need to understand what ketostix actually measure, and more importantly, what they don’t. Generally speaking, ketostix measure excess ketones in your urine. They are considered excess, because they are removed from your serum and shunted to your urine by your kidneys. Their caloric content is thereby wasted. Of the three types of ketones (acetate, acetoacetate, and beta-hydroxybutyrate) produced by your body, ketostix only measure acetoacetate. This is extremely important to understand, because it turns out that your body produces different quantities of these different types of ketones depending on how long you’ve been in ketosis. If you’ve been in ketosis for a while, you’re going to see a reduction in the “intensity” of what you register on your ketostix for two reasons: A change in the relative volume of the ketones produced/present in your body A reduction in the volume of ketones in your urine as your kidneys reduce the amount they secrete Both of these are covered below. Changes in the types of ketones you produce When you first start your ketogenic 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 Ketosis Cause Kidney Damage?
The ‘Lean for Life’ program is mildly ketotic, and only for a brief portion of the program. It has not been associated with kidney damage or disease in individuals who have normally functioning kidneys. Concerns regarding undue stress on the kidneys are often aimed at very low carbohydrate, very high protein ketogenic diets. Few studies have shown any actual damage, however. (Note: Although the Weight Loss portion of the ‘Lean for Life’ program is mildly ketogenic, it is not considered to be exceptionally “high protein” for most individuals.) Dietary ketosis is among the most maligned and misunderstood concepts in nutrition medicine. Particularly among researchers who don’t actually treat patients, ketosis (the presence of ketone bodies in the urine) is often confused with ketoacidosis, which is a life-threatening build-up of ketone bodies due to muscle wasting and dehydration as in states of shock or uncontrolled Type 1 diabetes. In the Type 1 diabetic, the absence of insulin leads to a toxic build-up of blood glucose and an extreme break-down of fat and muscle tissue. This condition doesn’t occur in individuals who have even a small amount of insulin, whether from natural production or artificially administered. Whereas patients in ketoacidosis are closely monitored in Intensive Care Units, individuals in ketosis are amongst the healthy, active population. Dietary ketosis is a natural adjustment to the body’s reduced intake of carbohydrates as the body shifts its primary source of energy from carbohydrates to stored fat. The presence of insulin keeps ketone production in check so that a mild, beneficial ketosis is achieved. Blood glucose levels are stabilized within a normal range and there is no break-down of healthy muscle tissue. It would be diffi Continue reading >>