Stopping Ketosis

[CelinaLambeth 13]

I have been dizzy to the point of nausea and have had moments where I have to hold onto something to keep from passing out because my vision tunnels. I haven't had the slightest clue what's happening. BP and blood sugar are normal. I had a nurse come to my home recently to draw labs for a life insurance policy I am applying for. The labs showed that I am spilling large amounts of Protein into my urine. Everything that I have read online states that you don't spill protein into your urine from a high protein diet. Not to mention that my protein intake is minimal due to the size of my stomach. I called my sister who has been a nurse for 15 years to talk about the lab results. She told me to go use a urine ketone test strip, we have those on hand because my husband and oldest son are type 1 diabetics. Sure enough, off the charts. Here's the thing, most everyone of the forum is going into or happy they are in active ketosis. I, however am not and feel like its unnecessary. I had gastric bypass to permanently limit Portion Control and my diet will forever be changed. How is that not enough? I do not want to be in ketosis so I am slowly adding healthy carbs to my diet. Anyone out there have bad reactions to ketosis? I feel like I may be the only one with negative reviews on ketogenic but my kidneys are struggling right now. Seeing my primary care first thing tomorrow. I had labs right before my surgery and all was fine. 2 weeks post op and the diet is making me sick.

[catwoman7 10,859]

I would say most bypassers are not on ketogenic diets once they're a few months out. Many are at first, though. The only time my diet was ketogenic was during the liquid phase. Once that was over, my clinic promoted a more-or-less balanced diet (although I know many clinics recommend a low carb diet until you're in maintenance). Most of the WLS patients I'm friends with have been in maintenance for awhile (sometimes a long while). Some do Keto (or IF....or Weight Watchers) when they want to lose a few pounds, but otherwise their diets are fairly balanced. (btw - when I want to lose a few pounds, I count calories and watch my portion sizes - but different strokes for different folks...)

Edited December 13, 2020 by catwoman7

[Arabesque 6,471]

The vision tunnelling could be from orthostatic low blood pressure. That means your pressure drops on rising to standing & then equalises a few seconds later. I take a couple of steps & then everything goes black & then comes back again. I used to randomly experience this now it happens frequently every day. When it occurs I stop moving & try to touch a wall, a table, someone just to ground myself for those few seconds.

If this is also coupled with tremors, weakness & feeling like fainting it could be a hyperglycaemic event. I have those too now occasionally. Eating a few blueberries or grapes help relieve the symptoms (or a ‘medicinal’ rum ball as I had to have last week after an attack).

Ketosis occurs because of being on a low calorie diet & having less glucose available in your body. Low glucose has links to diabetes & can cause hyperglycaemic events.

These may not be what’s happening to you but just something to also consider. Things do go a bit haywire after surgery as a lot of hormones are released into your blood stream from your fat as you lose weight. My liver suddenly wasn’t functioning normally & my cholesterol went up. It all stabilised again when I reached maintenance & was eating a little more.

I hope you find some answers soon. Good luck.

[WishMeSmaller 1,270]

I was in ketosis for about the first two-three months post-op. There was no way to get in all the Protein I needed with eating a more balanced diet. It was not by choice. My diet is more balanced now that I can eat more, and I am out of ketosis.

I agree completely with @Arabesque. Your body goes pretty haywire the first few months after surgery. Your hormones get out of whack. One of my liver enzymes was high at my first lab check 2-3 months out, but my surgeon was not worried about it, so I didn’t worry either (I am also a nurse). I also get the lightheaded wobbles frequently. It usually happens when I make quick moves or go from sitting to standing. I “run” into walls and have to catch myself. I am pretty sure it is orthostatic blood pressure changes.

It is a good idea to discuss your concerns with your surgeon. They can let you know if what is going on with you is “normal” after weight loss surgery and help you fix anything “abnormal.” Good luck!

[catwoman7 10,859]

6 minutes ago, WishMeSmaller said:

One of my liver enzymes was high at my first lab check 2-3 months out, but my surgeon was not worried about it, so I didn’t worry either (I am also a nurse).

my liver enzyme levels were abnormally high when I had them checked sometime during that first year, too. I was told that's fairly common because rapid weight loss is really hard on livers - and the enzyme levels usually normalize once the weight loss really slows down. They were rechecked when I was about 18 months out, and my PCP was right - they were normal again.

[RickM 1,747]

Stopping ketosis? Yes and no, depending upon how one defines it. As far dropping ketones that are detectable in a urine test, that is a normal result of burning off your fat stores - which is what we are trying to do - irrespective what diet is used. All it takes is a suitable caloric deficit, so that is pretty much unavoidable if you are losing the weight that you want to lose.

If one is aiming for high numbers or pretty colors on a Keto stick, and gushes about how the bad breath and body odors that they are getting is a sign of burning fat, then no, that is not at all necessary. I followed a very strict "no fad diet" regimen - no Atkins, Ornish, Paleo, South Beach, Zone, Keto, etc., and had to work to stop the loss when I approached goal weight.

I quite specifically avoided symptomatic ketosis (along with other classic low carb diet symptoms such as fatigue, lethargy, brain fade, hypoglycemia, etc.) by maintaining as balanced a diet as reasonably possible within our post bariatric Protein and low calorie requirements, though ketones were detectable in the normal urine tests - that is normal when metabolizing the fat. One does not need to go overboard on consuming excess fats to drive one into ketosis - that is just part of the keto fad and has nothing to do with burning your fat stores in losing weight.

The protein in your urine may just be a passing thing (no pun intended...) or may be indicative of something else. I have often passed detectable amounts of protein in my urine, even well before WLS, but that's just me. It can be a sign of possible kidney problems, or maybe not - it is something that we monitor. Our post bariatric diets are not so much high protein, as they are adequate protein bur low on everything else; in a year or two when you are much lighter and maintaining your weight, your protein levels should be about the same as they are now, but everything else will be higher to fill out the extra calories that you need to maintain, and to provide the nutrition that you need.

If you look at bariatrics historically, you find that dietary style (low fat, low carb, keto, paleo, etc.) makes very little difference to overall weight loss, as that is primarily determined by the caloric deficit created by eating so little for that first year or so. Indeed, if you look back 20-30 years ago, patients were often advised to "eat like you always have, just less...." and it worked. Of course, what didn't work was them maintaining the loss as they never learned to eat sustainably to maintain their weight. So, it is entirely reasonable to eat a basically healthy diet that, for a time, is protein biased (we can supplement most everything else) and not worry about whatever the fad diet of the day happens to be - eat with an eye towards how you should be eating five years from now. Those who follow the fad diets have the same problem that non-WLS dieters have - learning how to eat sustainably once they have lost the weight and no long have to "diet".

[CelinaLambeth 13]

Thank you everyone for helping put me at ease. I saw my doctor yesterday whom said to never do labs right after surgery, they will come back with some alarming numbers. I did not know this when the nurse came by to run labs for a life insurance policy I applied for. He said my liver and kidney function are great and I am in fact in ketosis due to the inability to get a full and balanced meal in. My body is (more or less) in starvation mode and my faint feeling is a side effect of minimal nutrition. He said as soon as I am able to have a full balanced meal, I will then have the carbs and energy required to function better. He told me to hang on and slowly add more carbs in so that my body wont continue to behave like its in shock. I have added lots of fruit and make cranberry/water mixes. I am feeling so much better. I just wished my surgeon would have put this in the discharge paperwork somewhere. I had no idea these side effects were possible post surgery. I was sent home and told I'd feel great......