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RKOTTEK's Photo RKOTTEK Posts: 20,060
1/21/17 10:32 P

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From the Sparkpeople site.

Alcohol can interfere with your blood glucose control, both raising and lowering blood sugar. Once in your system, alcohol initially lowers blood sugar, which can lead to hypoglycemia (low blood sugar). Some alcoholic beverages can raise your blood sugar because of their high carbohydrate content. To prevent your blood sugar from going too high, avoid sweet wines, liqueurs, and sweetened drinks like daiquiris, margaritas, pina coladas, etc. and choose lower-carb drinks.

Because alcohol can be diuretic it is even more important to maintain hydration
Cheers



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_RAMONA's Photo _RAMONA Posts: 11,294
1/21/17 12:53 A

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I'm glad you clarified, Jules. I never knew that dehydration goes hand-in-hand with ketoacidosis.

If your gut is damaged (and it sounds like it is... if you are gluten intolerant it definitely is), you may have absorption issues, and you may not be getting enough nutrients out of your multi/food before they pass out of your body... which is why taking extra keeps more in your system so that it is always available. Most people with autoimmune issues (diabetes is an autoimmune disease) have gut damage and malabsorption issues.

Additionally a multi is not formulated to address keto needs, and is not enough. When you are eating very low carb (keto) you are constantly flushing out mineral salts. Additionally, if you are well hydrated, this contributes to the issue (the more you pee, the more you flush out, the more you need to take in), so most people eating keto do well to use salt generously, and get extra potassium and magnesium... especially if they have some symptoms of low-carb side-effects.

Now, I absolutely understand that is the nausea that is the problem, and that you believe it's the keto-breath that is triggering the nausea.

My point is that it may not be wise to simply assume that the nausea is only a result of keto-breath, and that it might be wise to make sure it's not a symptom of electrolyte imbalance.

As for the breath, and the resulting nausea, this is also why I suggest playing with your carb percentage (up the carbs) and see if you can get a better balance for your own body. Since you're not trying to lose weight, nor are you treating a seizure disorder, your level of ketosis doesn't have to be at maximum level, or even very high, to get the benefits of a Ketogenic diet. There is no evidence that the higher the ketosis the greater the benefit. This is also why I suggest a blood ketone meter. It will tell you what your true keto levels are. You can have really good blood ketone levels and be producing very little colour on your ketostix.

Another way to achieve ketosis, and eliminate the issue of keto-breath is to raise your carbs and use Intermittent Fasting to keep yourself in ketosis.

Finally since nausea has been a problem for you much of your life, I would encourage you to check out the possibility of functional nausea (it's neurological in nature, involving the autonomic nervous system). There are ways of dealing with this that may be really helpful to you at this juncture.

I'm glad you're keeping stuff down at this point. I really hope it continues!
emoticon

Edited by: _RAMONA at: 1/21/2017 (00:56)

Dr. Jason Fung: "Holy consensus, Batman. With so many 'experts' from Michelle Obama to the USDA to virtually all of the medical professionals (including doctors and dieticians) agreeing that 'Eat Less, Move More' is the way to go, you might think that it is 100% unquestionably true. But here's a queer thought... if we all agree that we know the cure for obesity, and we've spent billions on educations and programs - why are we getting fatter? In other words, why does this 'cure' suck so bad?


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1/20/17 9:49 P

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I'm gonna update and give some more clarification :)

Debbie, I love ginger tea so I'm going to go to the korean grocer and get some! It's yummy and if it helps my nausea, then BONUS! I really think I do have some sort of grain intolerance as well because now that I'm not eating any, I notice that I do not have the upper and lower GI issues that I used to. I had terrible gas, bloating, constipation, and upset stomach. All of that is gone. I might try eliminating dairy and see where that takes me too.

Ramona, I take a multivitamin and I thought that my bases were covered. Is 100% daily not enough? I get a LOT of salt as far as electrolytes. It's not that my breath that is a problem per se, it's the nausea that it causes. When I can't hold down food, that is when I get into medical distress (which I will clarify later.)

James, before I went into ketoacidosis, my blood sugars were pretty well in check. My doctors looked over my glucose meter history and there was nothing higher than 140s. They can't figure out what started me throwing up everything. Did I have a stomach bug? They tested me for all sorts of stuff viral and bacterial and nothing. The constant throwing up led to extreme dehydration. The dehydration let to my blood getting acidic and it went downhill from there. The first thing they did in the ER was give me IV fluids. So apparently, dehydration is dangerous for all types of diabetics. Also, I asked my doctor how my blood sugar could get so high when I couldn't hold down ANY food or fluids and he says that is what happens when a diabetic gets severely dehydrated. Even if they don't eat, their blood sugar goes up.

"Ketoacidosis is always accompanied by dehydration, which is caused by high levels of glucose in the blood. Glucose builds up in the blood if there is not enough insulin to move glucose into your cells. During an episode of ketoacidosis, it is common for blood sugar to rise to a level over 400 milligrams per deciliter. When blood sugar levels are so high, some sugar "overflows" into the urine. As sugar is carried away in the urine, water, salt and potassium are drawn into the urine with each sugar molecule, and your body loses large quantities of your fluid and electrolytes, which are minerals that play a crucial role in cell function. As this happens, you produce much more urine than normal. Eventually it may become impossible for you to drink enough fluids to keep up with amounts that you urinate. Vomiting caused by the blood's acidity also contributes to fluid losses and dehydration."

So in short, the keto breath becomes a big problem if I am not able to hold down food and water because of nausea and throwing up. Then I become dehydrated, my blood becomes acidic, then. . .I guess it is a trip to the ER.

Right now, although I am dealing with an unsettled stomach, I'm able to hold down most my food and water and my BS is near 100. I test several times a day and drink extra water.

At the point I can no longer hold anything down. . .because of the taste in my mouth. . .is when I have to take drastic action.

RKOTTEK's Photo RKOTTEK Posts: 20,060
1/20/17 7:08 P

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I am not advocating alcohol as a permanent addition to diet, just as an occasional and temporary fix for nausea and lightheadedness.
the fact that the liver metabolizes this first and quickly can help rectify issues that excess ketones may be producing.
cheers



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DEB_RN's Photo DEB_RN SparkPoints: (4,291)
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1/20/17 3:22 P

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Take a look at my meal tracker... I'm pretty sure it's public. I set it up years ago! We are dairy free, soy free, gluten free, few nightshades and occasional eggs. We only eat butter as that seems to be tolerated by most.

Debbie

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1/20/17 3:09 P

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Debby, I would be interested in getting some info on your AIP+keto diet you are following. I have recently given up completely on the dairy since I am sure I am sensitive to that as my sore joints can attest to when I eat it. Eating keto without dairy isn't easy. Anyway, would you be able to share what you are doing?...perhaps on the main chat line since this is more on keto breath

Cynthia
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1/20/17 2:18 P

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In my recent medical research, I learned that the Inuits(Native Eskimos) eat NO carbs. There just aren't any available. They live completely on Fat and Protein from fish, whale, seal, occasional caribou, etc. They have NONE of our diseases! Once they move to modernized areas, they develop our diseases within 2 generations! The researchers that studied them ate the same thing the Inuits ate, out of necessity, and reversed a lot of their own diseases. Unfortunately, when they went back to civilization, they settled back into their old ways and the diseases returned. Our bodies will adapt without the carbs. Backing off carbs slowly eases most of the discomfort as our bodies shift from burning carbs to burning fat for energy.
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-JAMES-'s Photo -JAMES- Posts: 11,328
1/20/17 1:59 P

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JULESHIDENKA,

You need to keep in touch with your medical doctor and team about your condition.

Here are my thoughts, not advice, just thoughts....

Ketoacidosis is not to be confused with Ketosis. Ketoacidocis, which is what you had and is pretty rare, is when your blood sugar is too high for too long. Typically this can occur in type-1 diabetics (no insulin). I can well see that a doctor would prescribe insulin for this, or other diabetic drugs like metformin, to make existing insulin more effective. You organ issues also seem to be related to very high blood sugar.

www.myvmc.com/diseases/diabetic-keto
ac
idosis/


But either way these treatments get blood sugar out of the blood and into cells, either lean cells or fat cells. Insulin has a nickname of "the fat storage hormone".

Eating Keto means less carb intake, less high blood sugar, less need for insulin. One need not worry about how low carbs go, carbs are not required (I've probably said this before), in Wikipedia about carbs:

en.m.wikipedia.org/wiki/Carbohydrate

Where it says:
"Carbohydrates are a common source of energy in living organisms; however, no carbohydrate is an essential nutrient in humans."

The whole body can function on fat and protein, no carbs needed. Most of the brain can function on ketones (from dietary fat), with one small exception, one part of the brain does need glucose, about 30 grams a day, however even if you eat zero carbs, your body will convert some protein (which is built from amino acid pieces) into glucose.

www.marksdailyapple.com/how-much-glu
co
se-does-your-brain-really-need/


That process is called gluconeogenesis (make new glucose)
en.m.wikipedia.org/wiki/Gluconeogene
si
s



Edited by: -JAMES- at: 1/20/2017 (14:00)
James


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Starting weight : 195.0 pounds (June 7, 2012)
Final weight : 168.2 pounds (July 23, 2013)


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_RAMONA's Photo _RAMONA Posts: 11,294
1/20/17 11:13 A

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You're welcome!

You haven't said... are you watching our potassium/magnesium/electrolyte levels to see if that may be part of the issue?

I understand how your past experience would lead you to think it's your breath that's the problem, but it may not necessarily be. I hope you'll try adding in bone broth (sipping this can ease nausea), more salt (Herbamare in hot water is a great/tasty way to replenish mineral salts), an avocado a day, 20 minute tub soaks with Epsom salt added (replaces magnesium... you only absorb as much as you need).

At the very least, these things can't hurt you, and they could help.

Keep us posted as to how you're doing.


Dr. Jason Fung: "Holy consensus, Batman. With so many 'experts' from Michelle Obama to the USDA to virtually all of the medical professionals (including doctors and dieticians) agreeing that 'Eat Less, Move More' is the way to go, you might think that it is 100% unquestionably true. But here's a queer thought... if we all agree that we know the cure for obesity, and we've spent billions on educations and programs - why are we getting fatter? In other words, why does this 'cure' suck so bad?


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1/20/17 11:13 A

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Have you tried fresh ginger tea for the nausea? How are your menstrual cycles? Do you have any hair loss? I ask because some of this could be hormone related. We often have more than one imbalance in our bodies. The belly bloat could be just inflammation as mine was. Once I went on the Autoimmune Protocol Diet(AIP), that inflammation went away. It was amazing not to have that miserable feeling! I am now AIP + Keto as I try and melt some of this stubborn fat away. I have been overweight since I was 5 yrs old. It's old fat and it has a lot of toxins stored in it. I'm now losing weight and inches very slowly, but at least it's going in the right direction. The best part is not being hungry all the time. Yesterday we almost forgot to eat lunch! THAT never happens in THIS house!

Debbie

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1/20/17 10:56 A

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I'm also very impressed with the wealth of information that the members of the team have! It makes me feel safe asking questions and further, everyone has been so generous with their time and knowledge! This team rocks!!

I don't think my doctor friends think that keto in and of itself is a dangerous thing. They didn't say anything until my nausea returned. I've read on Diet Doctor that ketoacidosis is a issue that concerns primarily type 1 diabetics. But the fact that a few months ago I was in the ER for precisely that concerns them. If I can't eat or hold down water/food. . . that is exactly where Im headed. Not because of the keto. . .but because of the nausea.

My blood sugar has been creeping up. . .but slowly. Until the beginning of this week, my fasting was 100 or lower. The past 2 days it's been in the 140s fasting and I've ate less than before because of the nausea so I'm a bit concerned.

I've done the macro thing (Thanks Ramona!!!) and I'm going to stick with it in regards to percentages/actual values. I'm going to try to push through the nausea and hope it's just a temporary thing.

Time to put on my big girl panties!!!! HAHAHAHA

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1/20/17 12:21 A

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Jules.. I'm not going to give any advice because I couldn't add anything that hasn't been mentioned already. This is such a knowledgeable group. I am highly impressed.

I just wanted to say that I hope you get past the nausea and such and start feeling better. I used to have the metal mouth... but now I don't. So it is fleeting. I drank a lot to flush it out... but you said you are doing that already. You didn't mention what your BG was. I am assuming it is good while you are doing this.

Cynthia
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UZZoP_nIc2HCLax9YbKBs8-8eL3yrUdp6uvCAt
c10/edit#gid=30


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_RAMONA's Photo _RAMONA Posts: 11,294
1/19/17 11:22 P

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Respectfully, your doctor friends are misinformed (if you're now off insulin, you're not going to suddenly go the other way as long as you are not eating carbs). First of all, generally type 2 diabetics don't have to fear ketoacidosis. Eating a LCHF diet is the remedy to diabetes, and nutritional ketosis cannot become ketoacidosis... though continuing to monitor your blood sugar levels is not a bad idea. If you are worried about ketoacidosis, then checking your blood ketones is even more important, because while eating a ketogenic diet, the ketostix become useless to tell you if you really are in trouble.

Ketosis vs Ketoacidosis
ketogeniclifestyle.com/the-ketogenic
-d
iet-summary-of-lyle-mcdonalds-book/kR>etosis-vs-ketoacidosis/


Under the circumstances you've described, and from everything I've read (A LOT) the ketogenic diet is probably the best for accomplishing your goals.

Since you want to gain weight I strongly recommend plugging your numbers into the keto calculator I linked to... it has a gain weight option.

I also really think you have to take a more moderate, well-considered approach to this. You need a lot more information so that you can trouble-shoot for yourself. Your personal situation is very different than that of most people here using a ketogenic diet.

As a first step, try to address your nausea by addressing a possible electrolyte imbalance. If that doesn't help then look at raising your carbs a little. I think it may be a mistake to simply attribute the nausea to "yuck mouth" just because of past experience.

Above all, please, get a copy of the Art and Science of Low-Carb Living by Phinney & Volek, and read Dr. Fung's blog, Intensive Dietary Management. These are the best resources for your personal situation.

Here's the link to Dr. Fung's blog (he strongly advocates a ketogenic diet for the 'cure' of diabetes and obesity):

Type 2 Diabetes Lecture Series
intensivedietarymanagement.co
m/categor
y/lectures/type-2-diabetes-le
cture
-series/



You also may want to re-read my previous post... I was editing and we cross-posted. I've added in information that you may have missed.

Wishing you the best!




Edited by: _RAMONA at: 1/19/2017 (23:31)

Dr. Jason Fung: "Holy consensus, Batman. With so many 'experts' from Michelle Obama to the USDA to virtually all of the medical professionals (including doctors and dieticians) agreeing that 'Eat Less, Move More' is the way to go, you might think that it is 100% unquestionably true. But here's a queer thought... if we all agree that we know the cure for obesity, and we've spent billions on educations and programs - why are we getting fatter? In other words, why does this 'cure' suck so bad?


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1/19/17 11:05 P

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Oh yeah and also, I'm trying to GAIN weight. Today, I weight 124 but I'd like to be about 135 or more but more lean and more muscle. I'd like to be strong. I have a VERY high body fat percentage at this weight. Close to 30%. I don't think this is healthy and because I'm diabetic and have a LOT of visceral fat, my fat is around my mid section.

I don't have a lot of subcutaneous fat on my hands and feet and such. It's very veiny and old looking. But my belly? I look 17 months pregnant.

So I want more muscle and I'm trying to get rid of visceral fat. I stumbled across the ketogenic diet and it said that it was very effective in doing this. I was running 5 miles a day and starving myself but I NEVER got rid of the belly fat.

Like those starving children in Africa with the bloated bellies and stick thin arms and legs? That's me.

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1/19/17 10:59 P

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I think you are absolutely right.

Today, I didn't eat that many calories on purpose. It's because I'm just so nauseous that I can't eat. I was eating 1000 - 1300 calories and about 20g of carbs. I actually felt good until this yuck mouth started.

I talked this over with my physician friends and they said that instead of worrying about ketones, I really need to worry about my blood sugar. If my blood sugar is going up and I'm not eating sugar or carbs. . . .they say it means I'm entering or am in ketoacidosis.

Maybe I should quit doing this until I'm under the care of my endocrinologist? The reason I'm just very hesitant is because she pushes a diet with LOTS of whole grains etc and she wants me to stay on insulin. I've been off of it for a month and I want to go in and take an A1C test to see if I'm doing okay without insulin.

I'm doing this on my own and keeping it a secret from my endo because I don't think she is open minded enough to consider this safe. . .but at this point I'm thinking I might not have a choice?

It really bums me out because I was so proud of sticking to this and I was starting to feel good.

I really appreciate your input Ramona, it's very valuable to me.

_RAMONA's Photo _RAMONA Posts: 11,294
1/19/17 10:34 P

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You know, all the ketostix tell you is how many ketones you're peeing out (not using - WASTING). They're not telling you how high your actual keto level is. It takes time for the body to adapt to using ketones efficiently for fuel, so initially you pee out more than you actually use.

Really dark ketostix can also mean you are dehydrated, which can also cause nausea.

Additionally, at the level of fat you are eating, the dark purple can mean that your ketones are simply excess dietary fat converted and peed out... no matter your level of ketosis, if you are eating very high fat, you will produce more ketones than you need just because that's how fat is metabolized.

To really determine what your level of ketosis is, you'd be smart under the circumstances to invest in a blood ketone meter and test your blood ketones (the gold standard). Optimal ketosis (as per blood ketones) for weight loss is 1.5 - 3.0 mml, and if you don't have significant weight to lose, as long as your ketones are over 1.0 mml you are doing great. There is no evidence that the higher the ketones the greater the weight loss, or even health benefits, unless you are using a ketogenic diet to control seizures.

You may find this helpful:
ketodietapp.com/Blog/post/2013/11/30
/K
etosis-Measuring-Ketones


Being keto-adapted means that you are using most of the ketones you are producing for energy, and you will not pee out as much. Many people make the mistake at this point in assuming that they are somehow "knocked out of ketosis."

Once you are keto-adapted (eight weeks or so), I would suspect, because you don't have a huge amount of fat to eliminate, that you could raise your carb levels some without any loss of ketogenic benefit.

Honestly to do this long term, you need a more balanced approach if you're going to feel well. 300 calories and only 5 g carbs (is this for the day?) is really low.

Also, try making sure that you have enough salt/magnesium/potassium and see if that makes a positive impact on your nausea. At the levels you are eating, it is very possible that your electrolytes are out of whack, which would cause nausea. If things are going as they should, you should feel great on keto, not sick and nauseous.

Have you used a keto calculator to figure out what your calories/macros should be?

This is a really good one:
ketodietapp.com/Blog/page/KetoDiet-B
ud
dy




Edited by: _RAMONA at: 1/20/2017 (10:40)

Dr. Jason Fung: "Holy consensus, Batman. With so many 'experts' from Michelle Obama to the USDA to virtually all of the medical professionals (including doctors and dieticians) agreeing that 'Eat Less, Move More' is the way to go, you might think that it is 100% unquestionably true. But here's a queer thought... if we all agree that we know the cure for obesity, and we've spent billions on educations and programs - why are we getting fatter? In other words, why does this 'cure' suck so bad?


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1/19/17 9:23 P

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Thanks so much for the suggestions!!!!

Today, it's 921 PM my time and I've only eaten 300 and some odd calories. 5 grams of carbs. My keto pee testing strips says I've got big keto!!! But I feel so sick (nauseous)

I'm considering going to my doctor to get maybe a month supply of prescription anti-nausea medication. I don't know how she would feel about that.

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1/19/17 6:20 P

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Um... considering alcohol stops the production of ketones until such time as the alcohol is completely metabolized, I would think alcohol would be counter-productive in terms of maintaining ketosis.

The body perceives alcohol as fuel and burns the most easily accesible fuel first: alcohol, sugar/carbs, and finally fat (ketone production). If you're not burning fat, you're not producing ketones. Also, alcohol is metabolized in the liver, and fat is converted to ketones by the liver... the liver can only do one thing at a time.

If you have low-carb symptoms of nausea and lightheadedness, I'd strongly suggest trying bone broth, pickle juice, salt, magnesium, potassium (anything that replaces minerals and electrolytes) before alcohol.



Edited by: _RAMONA at: 1/20/2017 (10:30)

Dr. Jason Fung: "Holy consensus, Batman. With so many 'experts' from Michelle Obama to the USDA to virtually all of the medical professionals (including doctors and dieticians) agreeing that 'Eat Less, Move More' is the way to go, you might think that it is 100% unquestionably true. But here's a queer thought... if we all agree that we know the cure for obesity, and we've spent billions on educations and programs - why are we getting fatter? In other words, why does this 'cure' suck so bad?


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RKOTTEK's Photo RKOTTEK Posts: 20,060
1/19/17 5:49 P

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Try to stay well hydrated from the beginning of the day.
Ketones and protein metabolism produce toxic byproducts that need flushing from the body, hence plenty of fluid is required.

Whilst on the whole I agree with RAMONA"s answer, you may have undiagnosed migraine which can be affected by hormonal cycle and/or food and other triggers.

I find nausea and light-headedness can be assuaged by the intake of some alcohol.

it would probably be important to keep your Vitamin supplements up to date

Cheers



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1/19/17 5:32 P

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Hi, Jules. Sorry that you're having a tough time of it.

The keto breath should lessen over time (as you become more efficient at burning ketones), but some people are more prone than others. The most effective way to reduce keto breath is ease up on the degree of ketosis you are in (raise your carb levels in small increments until you are happy with the results). It's all about finding your own individual balance between maintaining ketosis and eliminating undesirable side-effects.

Here's an article specific to keto breath you may find helpful:
www.dietdoctor.com/low-carb/s
ide-effec
ts#badbreath


Here's one for trouble-shooting all manner of low-carb symptoms:
www.dietdoctor.com/low-carb/s
ide-effec
ts


Something else you could try is oil pulling, and add a few drops of essential oil to your pulling oil (it won't fix the root problem, but it does make your mouth taste a lot better for an extended period of time):
draxe.com/oil-pulling-coconut
-oil/



As for the nausea issue, have you ever been evaluated for the possibility of a condition know as functional nausea and vomiting?

25 million people suffer with functional nausea and vomiting. This is not a made up disease. This is not "in your head." This is not an excuse. It is a physical reaction to mental duress.

Check this out and see if it applies:
gitract.mngastro.com/mngi.nsf
/patient_
education/MNGI-9JVS6L.html



Best wishes!
emoticon


Edited by: _RAMONA at: 1/19/2017 (18:14)

Dr. Jason Fung: "Holy consensus, Batman. With so many 'experts' from Michelle Obama to the USDA to virtually all of the medical professionals (including doctors and dieticians) agreeing that 'Eat Less, Move More' is the way to go, you might think that it is 100% unquestionably true. But here's a queer thought... if we all agree that we know the cure for obesity, and we've spent billions on educations and programs - why are we getting fatter? In other words, why does this 'cure' suck so bad?


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1/19/17 4:05 P

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I'm at the point that I really need some help or I might just have to give up keto and I'm actually loving it.

To give a bit of back story:

I've been prone to nausea for several years. My bf says that he never knew someone who threw up so much. Car sickness, anxiety, motion sickness, sadness. They all make me throw up. Even certain smells.

About 3 months ago, I have a bought of nausea. I threw up constantly for 3 days straight and couldn't hold anything down. Not even water. If I tried to drink water, a few minutes later, I'd throw it all up. I went to urgent care and they ran some tests. I guess after the results came in, they wouldn't even talk to me. They pushed me out of the clinic and told me to go to the ER immediately. No explanation. . .they said they didn't have time.

The ER had the test results and they took me immediately in. See, I'm a type 2 diabetic and I was in keto acidosis? (Sp?) and they told me my organs were in the process of shutting down. I felt pretty much the worst I've ever felt in my life but I thought it was just a bad stomach bug. The nausea didn't go away for about a month. I was on prescription anti-nausea medicine. It was just a horrible situation because it cost me a lot of money to go to the ER even with insurance, I felt so awful, and I want to avoid this situation as much as possible.

In the present:

I have this disgusting metal/sweet taste in my mouth constantly. I drink water, I brush my teeth, I eat strong flavored food, I chew gum. . .nothing works except for sleeping. Then I can't taste anything. The taste is giving me bad nausea and I just can't find anything to make it go away.

I've researched this on the internet and everyone's consensus is that there is nothing that can be done and that it will go away on its own in several weeks. I can't wait that long.

So does anyone know of something that will help me? I'm desperate.

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