Was looking up information on non-diabetic ketoacidosis, and saw several references to, but not much info on, lactation in connection with ketoacidosis. Then I came across this case report:
Ketoacidosis associated with low-carbohydrate diet in a non-diabetic lactating woman: a case report
What is interesting here is that they report a ketone level of 7 mmol/L. While that’s far higher than what is considered nutritional ketosis range, and I sometimes see on charts as a “danger” or at least unhelpful range, usually I hear that ketoacidosis starts at 10 mmol/L (or recently virta had an article on Keotacidosis claiming it was 15-25 mM (mmol/L still, I think) range.
But, yea, their ph level of blood was slightly below 7.35 (apparently the base range for human blood?), and they had some pretty bad symptoms.
Note, this was not due to a ketogenic diet alone (and we don’t know exactly what form of the diet they were following beyond being “low carb, high fat”), but was a combination of LCHF while lactating, with lactation causing certain effects on the body to raise ketone levels higher.
I’ve seen some indications of this showing up in connection with lactation elsewhere, but haven’t found sources on that yet, and this indicates,
this is the first reported case in the literature of ketoacidosis, in a non-diabetic patient, associated with a combination of low carbohydrate, high fat diet and lactation.
So probably there is more to it than just that as well, but whatever it is it seems they couldn’t pin down the other factors leading to this.
EDIT: Realizing something of note, this woman appears to have started a LCHF diet 10 days prior to this incident, while already breastfeeding. If this was her first time doing it (we don’t know) she was still undergoing fat adaptation by that point, most likely. Would this have happened if she was already fat adapted before breast feeding? Open question I guess, and this is just a single case so it’s hard to say a whole lot.
