High HR, BP, poor kidney function since Keto...advice/insight appreciated


(Steph (Swansong75)) #1

I’m now 7 weeks in, have MS, high cholesterol & hypertension. Tuesday went to the ER for high bp, dizziness & HR of 158 while just walking from my bathroom to the sofa - maybe 20 steps between the two. My bp has been previously very controlled until about 3 weeks ago which is also when my HR jumped. Added Lite Salt to water & tried eating potassium rich foods - bp & HR briefly lowered then started climbing again. ER doc thought dehydration & electrolyte imbalance til he got my labs. Labs = sodium 141 (good) potassium 3.2 (normal limits) but BUN & Creatinine were both high & gfr was low (no prior abnormalities before keto). Follow up with doc yesterday said stop keto immediately. I stated that I’m not just doing this for weight loss (17 lbs to lose although I haven’t lost anything since week 1 water weight despite being in ketosis - 'large amount of ketones in urine) but for the health benefits specifically for MS & heart. I’m admittedly not very active & believe that’s part of the weight loss stall. I’m just frustrated. Doc said that keto is taxing my kidneys & causing all the other issues - that my body is screaming at me that keto is hurting me. I felt great for the first 4 weeks then bam! Down for the count. BP Friday was 180/110, currently 134/98 with meds. Resting HR goes up more each day, currently 96 by FitBit. As I’m writing this my HR is 120. For now, I’m sticking to my keto-friendly food but upped my carbs to see if there’s improvement. Follow up labs in a month. Anyone have insight to what’s happening?


#2

How much protein are you eating every day? What did your doctor recommend you do instead of keto? Did he refer to to a kidney specialist?

I’m not sure people realize this-- ketones in your urine can be a sign of problems as well as a symptom of following a ketogenic diet. If my BUN and creatinine were both high I’d be seeing a kidney specialist immediately. Keto shouldn’t cause this, but some serious disorders can.


(Steph (Swansong75)) #3

On avg my protein is 60g/day many times less than that. It could stand to be upped even. I’m 51y.o. 4’10" with 92.72lbs lean muscle. My doc was all over the place telling me how dangerous keto is, then later singing it’s praises - said no diet should cause you to have to supplement anything (I told her about adding Lite Salt to water and on food). She told me to eat a balanced diet, eat whole foods, cut out junk food - all of which I did (and told her so) when we went keto - threw out all sugar, processed foods & replaced with healthy keto-friendly (coconut oil & flour, almond flour, erythritol etc). She just wants to recheck labs in a month after not being low carb & not being in ketosis. Maybe keto exposed an underlying issue I was unaware of. I don’t know. I know my kidney function was fine on last labs prior to the current (just over 1 yr ago).


(Brian) #4

For 93 pounds of LBM, 60g of protein is pretty high, at least on the upper side of normal. Ever considered lowering that and increasing the fat, maybe?

(Just asking. Have heard several others suggest that some don’t do as well at that high a level of protein, especially the ladies.)


(Mike W.) #5

How did this compare to previous labs?


(Steph (Swansong75)) #6

Really? I was going off the KetoGains macro calculator which put me at 70g. I am tiny & with a sedentary lifestyle should eat around 1000 cal. More once I start moving my ass lol. I felt great for the first 4 weeks - eat fat bombs galore & loved it. I have stopped eating as much fat as I was initially (still enough to keep me in ketosis) but wonder if I’m doing something wrong. My initial gut feeling was potassium as when I boosted it, HR & BP started to back off but it was a lot I was adding to water & got scared of overdoing it. My gut still tells me it’s related to the potassium even though I’m technically ‘normal’ - low side of normal but still within normal limits. I don’t know how that tracks with kidneys though.


(Steph (Swansong75)) #7

Last year’s BUN = 17 (over 20 is high) now = 21 Creatinine was 1.03 (over 1.2 is high) now 1.0 (over .09 is high) gfr was 64 now 58 (should be >60.


(Nancy ) #8

I think maybe you calculated protein per kg, but used your pound number. 92 pounds is 41.8 kg, so .6 - 1 gm/kg = 25 - 41 gms per day… So maybe decrease protein and increase fat again. Just a thought.


(Consensus is Politics) #9

My gut feeling is protein is too high. Aren’t those kidney test showing too much protein? I seem to remember something about kidney damage being caused by too much protein. But I don’t think the amount you quoted would be too high.

You made the same mistake I usually do. Offered up information to the doctor. We should always let them ask the questions and let them troubleshoot from there.

Troubleshooting is my wheelhouse. When we troubleshoot something, listening to the customer can get you into trouble. You ask them what the problem is, but never ask them what they did to fix it. It will only bias your own findings, or prevent you from looking at things you normally would have looked at, but didn’t because you know the customer already did that. Much the same with doctors. You mentioned Keto, and since most doctors are clueless about it, they make assumptions based on that little knowledge. Hence the doc saying, “it’s dangerous”. Anytime anyone gives that kind of comment I want references. Why is it dangerous? How? When does it present? What else can cause that? Basic troubleshooting.

It’s not a bad thing to own up to. Let the medical experts do the expert assessment. If keto is a problem with that, it should come out during the docs assessment of the problem and he should see it, and ask you about it. Or he might just tell you he see’s a lot of ketones in your urine and has a concern.

Just because your electrolytes looked good on one lab test, doesn’t mean they are good the rest of the day. You may have just recently had a good amount of salts, before the labs. Then a few hours later your kidneys dumped out more salt into urine and you are low again.

First thing I would do is get a second opinion. A blind opinion. Give the second doctor your ailments, let him troubleshoot from there. If he doesn’t seem to be headed toward taking labs, then hunt that you would like to know if you are overdoing it on sodium/potassium supplements. That will probably scare him into getting lab work done. Leave keto out of it unless the doc just seems completely befuddled. Then add, “I’m on a ketogenic diet…”

What the heck, speaking of troubleshooting…

Have you made any, ANY, changes to your diet in the past month or two? Brand names? Maybe eating out? Maybe a relative cooking for you? My wife keeps cooking her own way. One of those ways includes adding sugar in marinades for meat. A lot of it. She also adds a ton of soy sauce as well. She also adds potatoes and carrots. If she makes me a coffee she will still make it the way I used to, with 3 or 4 spoons of sugar in it :persevere:. She is finally coming around to understand what carbs are. But it’s a tough but to crack. Language barrier when I try to explain it all. What I need to do is find a Korean language version of The obesity code. That might help out a lot.

Back on relatives cooking for you. They may say it’s keto, because they followed a keto recipe on the internet, but that doesn’t mean it’s keto. I recently saw a recipe for keto brownies. It had one cup of sugar in it. And used regular flour as well. Opposite of keto or even low carb. So watch what you eat with a critical eye. There are a lot of hidden sugars out there.


#10

Ok, so in all honesty your labs haven’t changed that much. Creatinine of 1.0 is actually within normal limits. BUN barely over top range. Your GFR is a little low, depending on your age, but honestly no different than last years.

Looking at your numbers, I take back what I said about rushing off to the nephrologist.


(Bunny) #11

“…One day, however, she got into an argument with one of the cardiac specialists about his exercise prescription for a patient. “I was always so frustrated because the doctors had no idea what they were talking about. I knew after a fight one day, I was never going to be listened to by them unless I was a doctor, too. So I went to medical school — because I was pissed.” …” - Low-carb profiles: Dr. Sarah Hallberg

Possibilities?

Adrenal Fatigue? and Orthostatic Postural Orthostatic Tachycardia Syndrome (POTS)? when starting a ketogenic diet?

Could take a while for your vital signs to return to normal if your just starting a ketogenic diet; not sure how long? And 6 months to become fully fat adapted?

Watch protein intake? Foamy Urine?

No Exercise?

Grains in diet?

Enough Omega 3’s from marine life e.g. seaweed?

Reversing Diabetes 101 with Dr. Sarah Hallberg: The Truth About Carbs, Blood Sugar and Reversing Type 2 Diabetes - Dr. Sarah Hallberg, DO, MS

Highlights:

You may have heard a lot about type 2 diabetes – but do you know what it actually does to your body?

In this video series, we’ll explore the causes of type 2 diabetes and how to reverse it.

  1. How food affects blood sugar
  1. Carbohydrate intolerance and insulin resistance
  1. How type 2 diabetes became an epidemic
  1. Treating type 2 diabetes—and why ‘eat less, exercise more’ doesn’t work
  1. The history and safety of ketogenic diets
  1. Research on ketogenic interventions for type 2 diabetes
  1. Ketogenic meals and food options …More

Other:

  1. Ketogenic Diet & Heart Health–New Research Updates 2018 by Sarah Hallberg, MD
  1. Researchers Determine That MS And Diabetes Are Closely Linked Diseases
  1. When a Second Chronic Condition Complicates Multiple Sclerosis
  1. Prevalence of Diabetes in Patients With Multiple Sclerosis
  1. Higher Risk of Multiple Sclerosis in Patients with Type 2 Diabetes
  1. The MIND Diet and Warfarin (Coumadin)

(CharleyD) #12

Do you drink a lot of coffee now that you’re keto?

My eGFR trended lower and lower and I wasn’t sure why. Until I did Feldman’s Cholesterol Drop Protocol which asks to abstain from coffee for a few days. 3 days without coffee and the eGFR value was back to normal.


(Juanita Macleod) #13

Where you fasted when blood taken? Recent meat ingestion lowers eGFR so this should be measured after a 12 hour meat fast to give a reliable result


#14

Your problem list is complex. Keep your primary care physician, if you like them. And consider a second opinion from a ketogenic diet doctor or functional medicine practitioner that may be able to give you clear guidance. Print out the advice thread to use as a prompts list.

A good way to find a ketogenic diet knowledgable doctor trail (to hunt one down) is to go to respected podcasts like 2 keto dudes, or livin la vida low carb, or web sites like Diet Doctor, or one of your choice, and listen to interviews. Then track down the contact information of any doctor you like the sound of.

You probably already know of Dr. Terry Wahls?


(Omar) #15

The Garmin Forrunner 935 is at least 10 to 15 beats per minute higher than a more professional heart rate monitor.

Device such as the Fitbit and the like you have to wear them very tight to the wrist for them to read the heart rate correctly.

If you wear them very tight they will read correctly, but I do not feel comfortable.


(icky) #16

I read a good piece of advice about the fitbit/ comfortableness/ heart-rate thing the other day…

It was to wear it “loosely” so it’s comfortable, but when you want an accurate reading, to “push it up your arm” because as your arm gets thicker towards your elbow, the fit will be more snug tight… Leave the fitbit/ device there for a few minutes (for as long as you want a more accurate reading) and then slide it back down towards your wrist again for more comfortable/ loose wearing…


#17

That is a load of nonsense! If you still have the same doctor
then find another one. I have been on keto for 4 months, I
saw my nephrologist 2 weeks ago as I had stage four kidney
disease. My HbA1c was 5.8 mmol/l and before was 10.
The specialist was amazed when he told me my kidney function
had improved by 25% in 3 months. The only thing I was worried
about was having ketones and glucose in the urine as I was on
Gardiance and had read about ketoacidosis. He conferred with
a colleague, an endocrinologist in Sydney by phone and they
decided to stop the gardiance and told me to keep doing
whatever I was doing (keto). With those test results and
multiple indications of improved health, you can’t be doing
anything wrong.