Ketosis

[MollyRN 28]

Agggghhh.... After all my complaining and research about the metal taste in my mouth, I am pretty sure now that I am in full ketosis. From what I read, it seems like a highly positive thing - meaning my body is no longer burning glucogen and has switched instead to burning fat (primarily because I consume practically no carbohydrates).

But seriously, can someone tell me if I have to live with the taste and pain in my mouth forever? Any long time bandsters have this issue? The nutritionist says that I don't have to eat carbs if I don't get that far (meaning, eating Protein first and then veggies...and not getting to carbs). I think I have about 30grams per day of carbs.

[jalomum 1]

you need carbs. Good quality un-refined, low gi carbs. Ketosis is good for short periods but I believe the fact that it burns so much fat means it releases lots of toxins into your blood that your kidneys will struggle with.

[Llyra 3]

You might consider reading a bit more about ketosis, which results when the liver is forced to produce ketone bodies during starvation and/or great physical stress. That metallic taste in your mouth is the result of a chemical process that produces acetone in your system which is released into your breath and your urine. There is some serious discussion about whether or not the liver is stressed during ketosis.

I haven't had pain or metallic taste during my six months with the band. In fact, I only ever experienced these things as a very young woman when I thought a diet of about 400 calories a day was a normal way to lose weight. At the very least, you should discuss it with your doctor. Pain and acetone breath is not normal with weight loss.

[MollyRN 28]

Completely agree about the pain things - in fact, that's my current topic on my blog.

I absolutely did bring this up with my doctor and they didn't seem really phased by it. I am eating about 1300-1400 calories per day and there are SOME carbs in the mix - although I admit, most of it is Protein as I really only feel good if I am eating about 65-75g of Protein per day. I really just wondered if there were people out there who had the same thing and when it went away...

My nutritionist sent me to a website that contains the following:

What is ketosis? Is it dangerous to be in ketosis? Ketosis is among the most maligned and misunderstood concepts in nutrition because it is often confused with ketoacidosis, which is a life-threatening condition. Ketosis is the accumulation of ketone bodies in the body, which is the end result of fat metabolism. When carbohydrate intake, as well as calorie intake, is sufficiently limited for a long enough period of time, the body is forced to use the fat stores for energy. When fat is burned (metabolized) it produces ketone bodies, which are then used instead of carbohydrates for energy. Excess ketones are excreted through the urine and their presence can be measured by testing the urine with a ketone stick. 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.

Ketosis is not an abnormality nor does it present any medical danger to the patient. Ketosis only presents a danger to the patient if the patient is an insulin-requiring diabetic, i.e. a Type 1 diabetic. Everyone is in SOME degree of ketosis all day. The most sensitive tests of ketosis ("NMR" and "blood ketone level") show that we all have ketones under any condition. For instance, anyone off the street (not dieting or exercising, having just eaten) may have a ketosis reading of 0.003 to 0.01; most of us are up to about 50 after not eating overnight; after completing a marathon, runners have readings of over 100; in the first week of a diet (whether or not it's "ketogenic"), the readings are around 200-300. It would be difficult to make a credible argument against ketosis, which has been used so successfully with both healthy people seeking improved fitness and nutritionally fragile children with epilepsy, diabetes, and cancer.

What is Ketosis? Simply stated Ketosis is a measurement of fats burning. Burned fat is broken down into Ketones, which the body uses for energy. When you burn a larger amount of fat than is needed for energy, the left over Ketones are excreted through the urine. Ketones can be measured by checking your urine with a Ketone stick. A pink to purple color indicates that you are in Ketosis. In addition to losing fat more rapidly, most people report feeling less hungry and more energetic while in Ketosis. Because the body burns fat stores, after it burns available carbohydrates, the Lean for Life weight loss plan is designed to help you achieve Ketosis by limiting your daily total carbohydrate intake as well as limiting total calories. Most adults achieve Ketosis when their daily carbohydrate intake is somewhere in the range of 50-100 grams. Dietary Ketosis itself is not dangerous to a normal, healthy person.

[2beskinny 4]

The research you posted reads a little "biased" IMO. "Lean for Life"...is that a diet book or something similiar? Not saying that I know more than the author, but it sounded a little "pro" ketosis if you know what I mean. My son is a Type I Diabetic so we, of course, avoid ketosis at all costs. I asked his endocrinologist about ketosis in the weight loss phase, etc. It is a stage that happens when your body depletes all of it's glycogen stores from the liver and truly begins living off of it's "stores" for energy - hence the weight loss. However, it does build up toxins in the blood over time which can be dangerous. It happens much faster in diabetics because they do not produce any insulin and those toxins can rise to a dangerous level quickly (which is what leads to a diabetic coma and eventually death if left untreated too long). A diabetic when in ketosis has a fruity smell to their breath...is that what your breath smells like at all? I'm not an expert on the rise of the toxin level in a non Type I person, but I believe in healthy weight loss and programs that you can live with for LIFE - not just a phase. The low carb thing does not work for long-term for me. I submitted to it in the pre-op diet and I'm trying hard to think about the carbs I chose to eat, but sticking to less than 60 a day (my doctor's recommendation) is difficult and I bet I only do it 3 days out of the week. The other days I seem to be hitting around 100. It's funny how lots of days my carbs seem to match my Protein grams. I do get lots of protein - sometimes over a 100 per day! Personally, I have decided that I'm not going to beat myself up over 100 carbs a day! I am losing at a rate that I am happy with, especially during pre-restriction or "bandster hell." Maybe after restriction sets in, the carb thing will be easier because I really will be FULL after Proteins and veggies :thumbup: 2nd fill in two weeks...bring it on because I am getting really hungry these days:drool:

[MaggieB 6]

I never had the metal taste but I did have the fruity breath. My kids would always ask me if I was eating/chewing gum or candy because of my breath. I try to limit my carbs but like one of the others I get in about 100/day. I am losing weight slowly, but I am satisfied with that.

[BetsyB 9]

At a caloric intake of 1300-1400 cal/day and 65-75 g of Protein, it may not be ketosis you're dealing with.

Are you getting plenty of Fluid? Are there other things that might be causing the pain/odor? Infection? Candidiasis?

Re: liver stress r/t ketosis--the liver actually works overtime during weight loss no matter what you're eating. It's not unusual for enzymes to increase during large weight losses---fat tissue is mildly estrogenic (which gives the liver something extra to contend with), and also stores many fat-soluble environmental toxins that increase its workload.

There is LOTS of evidence that suggests that the liver works harder during loss of considerable amounts of weight, but far less evidence that points to low-carb eating as an additional stressor.

That said, I would reiterate that if you're eating 1300-1400 calories, your diet is protein-adequate, not high protein--and I wouldn't be concerned at all---even if there were a concrete connection between high Protein diets and liver stress.

In your shoes, I'd work to rule out all other sources of odor/pain: mechanical injury during intubation, infection, dehydration, undiagnosed dental issues, meds (even Vitamins containing minerals can create a metallic taste--and if they're chewables, they can cause irritation to oral mucosa), and so on.

Just by way of comparison, I eat around 800 calories, and aim for 85-100 grams of protein/day. I do get carbs from veggies/fruits--usually around 50 grams or so a day. (That sounds very low, but in context of the low calorie intake, it's not as low as it sounds). I don't test positive for urine ketones on most days. (I only spot check--just to satisfy curiosity; I'm not aiming for ketosis, I'm just doing what works best for my body in terms of loss.) I don't have bad breath, and I don't have any oral pain (and I've never heard oral pain described as a feature of ketosis). My liver enzymes are well within normal limits, too--despite the hard work my liver is doing as my body gets rid of all of this excess body fat. (It really is VERY common for them to elevate during large losses--no matter how many carbs you eat.)

My son is a Type I Diabetic so we, of course, avoid ketosis at all costs.

You are confusing ketosis with ketoacidosis, which is a very common mistake (even among those who are well-educated about diabetes). They are very, very different conditions. Ketosis does not pose the risks you are familiar with and aim to avoid.

<---former diabetes educator married to a Type I diabetic for almost 25 years.

Edited August 29, 2010 by BetsyB

[MollyRN 28]

Thank you Betsy for weighing in....I was waiting for you!

I have done a low carb diet before and not had these issues. In fact, I feel like I am really not working that hard on what I am eating - Proteins first and really that is it. I am losing 2-3 lbs per week and I feel really good.

I will make a doctor's appointment at my regular doc about this. I don't have my typical signs of yeast problems - which I have indeed dealt with in the past. As far as this having to do with surgery, it started about 6 days into my pre-op diet so it cannot be related. I have not tested my ketones but I think I will buy the sticks today just to have that measurement in mind. Thanks.

[Froggie D 1]

Glad you are checking this out. I have done the high protien very low carb dieting in the past and with ketosis I got the metallic breath, but no mouth pain. By the way, I used breath strips or breath spray for the bad breath. They worked better than gum.

I do have to say that staying in ketosis for me was not easy. I had to stay under 20 grams of carbs per day. Pretty difficult.

I do not believe that ketosis is harmful, from what I have read, but probably not necessary to get a good weight loss. It does help control appetite and eating large amounts of Protein keeps your pouch full longer.

I am almost 5 months out form my surgery. I felt ketosis helped me pre-op and early on but now have added more carbs (try to focus on whole grains and fresh fruits) and am still getting good weight loss.

Good luck in finding out if you have other issues. Weight loss is a great goal, but for me overall health is more important than the numbers on the scale. I would certainly want to know there is nothing more serious going on!

Keep up the great work in weight loss and getting healthier.

Hurray for my band!!!!!

[Llyra 3]

Really interesting material on what is a controversial topic in weight loss! Thanks to everyone who is contributing and especially to Molly for bringing it up.

[shibalover 0]

I did the Atkin's diet years ago and lost 60lbs. I worked/strived to get into ketosis. That was the whole point, as far as I was concerned, about the diet. I had a metallic taste in my mouth, but no pain, when I was in ketosis. I tried to keep my carbs under 30g a day. Besides the taste in my mouth, the only bad side effect I noticed was some Hair loss, not too bad, but I remember worrying about it. I eventually stopped the diet, due to boredom. From what I read, it was ok to be in ketosis for periods of time, but not for long periods, as it was too much stress on kidneys and liver.

[2beskinny 4]

You are confusing ketosis with ketoacidosis, which is a very common mistake (even among those who are well-educated about diabetes).

Yes, I was! Thanks for the correction! BTW, my son was diagnosed at 10 months of age :frown:. He is turing 18 in 2 weeks and is doing fantastic. Knock on wood, he has not been in DKA or the hospital since his initial diagnoses. He excels at multiple sports, is a great student and has a bright future in college in academics and athletics (we are going through the recruiting process now). We are beyond proud of him...just taking some time to brag :thumbup:. I thought you might like to hear the success story given that you were a former Diabetes Nurse Educator and are married to a Type I. I am sure your husband appreciates your help and support with his disease. I hope that when my son leaves home he will find someone who understands what it is like to live everyday with Type I Diabetes!

[Whillow 0]

Ketosis was the basis for the Atkins diet -- I lost 93 doing that but whe ni added back in carbs i gained it all bad..

ketosis is not a bad thing,, it is different than the ketoacidosis that people confuse it for.

[MollyRN 28]

Thanks everyone for all of this input. The PREDOMINANT issue I have is the metallic taste, but my tongue feels the way it would feel if I ate a ton of citrus fruit, you know what I mean?

I am going to my PCP tomorrow - will write back with his determination.

[elcee 3,340]

Maybe you have geographic tongue.

Geographic tongue - Wikipedia, the free encyclopedia