Newcastle Diet and Ketoacidosis

[wenlock00]

Hi, I recently had a Hba1c test as part of an NHS MOT and the reading came in at 63. I also had some issues with my liver and enlarged blood cells.
They told me to go away and come back in three months and they would try the tests again. I went back to get the numbers as I was a bit uncertain about what was going on and did not want to wait three months to get things sorted. They said I might have type 2 diabetes. I had also been sleeping allot, feeling tired, and had gained allot of fat in the groin area. My waist was above 40. Being 16stone 3lbs and 6.1", I was overweight. strangely enough, my elder brother by two years was diagnosed with diabetes type 2 a few weeks earlier and my father also had it.

I had heard of the Newcastle diet and thought I would get on the case straight away. I am now on day 11 of the Newcastle diet. I do not have a blood sugar meter and decided against getting one as from what I have read they are not very accurate. I did however decide to buy some (Mission brand) urine test strips off Amazon as I was curious about weather I had achieved Ketosis or not. The last few days, I have been feeling sick and that I want to throw up but I am feeling OK today (Ketosis flu?).

After using a urine test strip I can see that I hit a high Ketosis level (dark red on the scale), my blood sugars are OK (test strip remains bright blue), however the PH value is about 8 suggesting Ketoacidosis or starvation? - is this something I should be worried about and go see the Doctor or is it normal given the nature of the diet?

 

[AndBreathe]

Hi, I recently had a Hba1c test as part of an NHS MOT and the reading came in at 63. I also had some issues with my liver and enlarged blood cells.
They told me to go away and come back in three months and they would try the tests again. I went back to get the numbers as I was a bit uncertain about what was going on and they said I might have type 2 diabetes. I had also been sleeping allot, feeling tired, and had gained allot of fat in the groin area. My waist was above 40. Being 16stone 3lbs and 6.1", I was overweight. strangely enough, my elder brother by two years was diagnosed with diabetes type 2 a few weeks earlier and my father also had it.

I had heard of the Newcastle diet and thought I would get on the case straight away. I am now on day 11 of the Newcastle diet. I do not have a blood sugar meter and decided against getting one as from what I have read they are not very accurate. I did however decide to buy some urine test strips (10 tests per strip) off Amazon as I was curious about weather I had achieved Ketosis or not. The last few days, I have been feeling that I want to throw up but I am feeling OK today (Ketosis flu?).

After using a urine test strip I can see that I hit the maximum for Ketosis (dark red on the scale), my blood sugars are OK (test strip remains blue), however the PH value is off the scale suggesting Ketoacidosis - is this something I should be worried about and go see the Doctor or is it normal?

I'll couch this post by saying I am not currently a registered health professional and nor have I undertaken the Newcastle Diet (ND), but would comment on the points you raise.

Those embarking on the ND give mixed feedback on the early days. Some immediately become invigorated, some suffer headaches, usually carb withdrawal and some have an energy dip, before their body gets used to the regime and starts burning it's own fat stores for energy.

The imminent vomiting is a new one on me, and that coupled with generally feeling unwell, and altered urine Ph would lead me to query (if it were me), if I had a urinary tract infection. Is there any protein or white cells in your urine (I can't recall which tests are usually on the Uristrips). On that basis alone, I might ask the quack to dip my urine, for a professional opinion. UTIs aren't to be messed with. In the meantime, up your fluids quite a bit, to stimulate throughput and flushing out your waterworks.

Vis-a-vis your ketones measure. I don't find that surprising, bearing in mind you are well into the ND. Ketoacidosis is usually associated with high blood sugars, although it can (although unusual) occur with lower glucose numbers.

Regarding your sugars and urine sticks. There's bad news and less good news. Frankly, in my view, urine dip sticks are the chocolate teapot of the glucose monitoring toolkit. They won't make any show unless your bloods are around 10, which isn't really the range you want to be operating in - particularly not if you are on the ND. Most people find their numbers moderate quickly. So, I'd say your urine sticks will not give you useful feedback, unless your bloods are higher. So you have an absolute safety net, but not real data.

Finger prick test meters, like many portable, budget electronics, are legally required to function to a tolerance of +/-15% of a venous blood score. That's all meters. But, for most of us, they are a completely invaluable tool, and I would judge my meter to have been my most valuable tool in modifying my diet to get control of my condition. You can see from my signature I have been pretty successful in turning my own position around, into an extremely healthy place. I am absolutely certain I couldn't have done that without finger prick testing.

But, back to your current predicament. If you are feeling fine today, keep a close eye on yourself, and if you have concerns, call NHS 111 to talk things through with them. If your urinary Ph remains off-kilter, I would be putting a call into my practise to talk it through, and ideally have then give your urine the once-over.

Does your Doc realise you are doing the ND?

 

[wenlock00]

Hi AndBreathe, many thanks for your response.

I have not seen the Doctor yet, they seem to communicate everything through the Nurse and they do not know I am doing ND (they might not of heard of it). Without going into detail I have a relatively low opinion of the NHS and the quality of care (unless your dying!) can be poor, and if I went back they might direct me to eat loads of Carbs and I do not want that to happen. I have had a further scout around on the internet and it is suggested that starvation (and meat, which I am not eating at the moment) increase urine PH levels. I think my body is still adjusting to Ketones so I will give it another week, do some more reading and keep testing the urine daily - if I think I am going to die then I will ring the NHS. The leaflet that came with the test strips suggested Diabetic Ketosis when PH is high and I panicked a bit, but I think that is more of a concern when blood glucose and PH are high at the same time and there can be other reasons as you have pointed out. I was feeling the need to vomit and feeling very cold but that does seem to be subsiding. It is challenging discussing these sort of things as a lay person (fully appreciated), but also there is a good possibility that the Doctor might not understand it either. I do have a history of Urinary infections so I will keep that in mind and perhaps get them to test that out via a laboratory sample when I go back for the fasting blood test in three months. As to glucose meter readings it is perhaps something I should invest in - they have not yet officialy confirmed my type 2 diabetes but I am fairly certain I will have it with an A1c score of 63 and generally how I have been feeling the last few years. The NHS has had an opportunity to test my Urine and blood sugar on a number of occasions over the years and they should do it more often. They did not bother to check my weight or my waist size either. They only identified my very high blood pressure after I asked them to test it and I had been going to the practice complaining of headaches for over three months

 

[Daibell]

Hi. I can't comment on Keto strips and whether you are in ketosis or even DKA. If you feel unwell then see the GP or go to A&E. The ND isn't the ideal diet approach for diabetics as it focusses on calorie reduction rather than carb reduction but it can achieve success with weight reduction and some reduction in blood sugar. The key thing is to get the carbs down. If they go down enough you will go into ketosis (fat-burning) which is fine. DKA happens when you burn fat and have very high blood sugar which is more likely if you are T1 and have very low insulin levels.

 

[Pipp]

Hey @wenlock00
Hope you are feeling better.
What are you using for nutrition on ND? Real food or meal replacements?
The most helpful Health Care Professionals when I used meal replacements for ND were the pharmacist staff where I bought the meal replacement products. They, with the approval of GP monitored my progress (weight, blood glucose, blood pressure, urine keytones, and general wellbeing) with compulsory weekly consultations and facility to phone them or drop in at any time I had concerns. GP nurse was seeing me every 2 weeks, but most supprt was from pharmacy. Perhaps you could find help from a local independent pharmacy too?

 

[wenlock00]

Hey @wenlock00
Hope you are feeling better.
What are you using for nutrition on ND? Real food or meal replacements?
The most helpful Health Care Professionals when I used meal replacements for ND were the pharmacist staff where I bought the meal replacement products. They, with the approval of GP monitored my progress (weight, blood glucose, blood pressure, urine keytones, and general wellbeing) with compulsory weekly consultations and facility to phone them or drop in at any time I had concerns. GP nurse was seeing me every 2 weeks, but most supprt was from pharmacy. Perhaps you could find help from a local independent pharmacy too?

Looks like you are getting better service than I , are you on the NHS?

I have a boiled egg for breakfast, a bowl of home made veggy soup for lunch, evening meal is a bowl of Salad or a Tesco slim shake not both. I take a multi-vitamin once a day to top up, I do not snack on salads or anything in between meals. I do not drink water, but probably have ten black cups of tea a day. I could introduce an extra slim shake and still be well within ND. Perhaps I am being too extreme, but I have had no sense of hunger. In terms of advice, there does seem to be many conflicting opinons around low carb, LCHF, Ketosis etc, so I like to form my own opinions after doing the analysis. The NHS put me on Statins a few years ago and that made my weight Baloon and my body took on loads of viceral fat that I have yet to loose, I think the Simvastatin was messing with my Testosterone levels (I had to explain this to the Doctor as they were not aware of it (a Locum, always a different one, many don't speak very good English and many are here doing Locum for the high money rates). So the Statins probably pushed me into the Diabetes 2 zone. My trust in the UK medical profession is low.

 

[Brunneria]

Ketoacidosis needs some very specific conditions to happen:
- high blood glucose
- low insulin (which is why it almost always happens to insulin dependent diabetics, and usually only to type 1 diabetics)
- sufferers also feel DREADFUL (bad enough for hospitalisation)

I'm going to go out on a limb and guess you have had carb flu and nutritional ketosis rather than ketoacidosis. But remember - i ain't a medical professional.

One way to test whether you have carb flu is to drink a lot of water - much more than usual. That helps. Also, have a mug of bovril, or add salt to food, or make a broth drink by putting a stock cube as in boiling water, and drinking as soup.

If these make you feel better, then the likelihood of it being carb flu just went up!

The reason for the extra water, and added salt, is that when we start lower carbing/'starving' or even just strictly cutting back, our kidneys dump a lot of fluid that has been held in the body. Because of the way the kidneys work, the fluid flushes electrolytes and salt out at the same time, leaving us feeling floppy, listless and heavy limbed. The nausea could well be 'withdrawal symptoms' from coffee, diet drinks, artificial sweeteners, flavours, processed foods etc. depends what you have cut out, to move to the ND.

When my Mr B gave up coffee he had a thumping headache for 3 days, and a rather short fuse.

If you are thinking of making this a long term way of eating, you would probably find the Volleck and Phinney book in my signature a really interesting read.

 

[wenlock00]

Thanks Brunneria that was really helpful.

The other thing is I did the dip test first thing in the morning.

I think I will increase the water intake, a bit more Salt (perhaps a pinch on the egg) , perhaps put in an extra slim shake and test the Urine in the evening.

 

[Pipp]

@wenlock00
My GP is NHS. Pharmacy is local independent business. Prior to embarking on ND I read the Taylor et al academic papers and copied them for GP to read and consider. Had he said it was not for me I would not have gone ahead. The meal replacements were Total Food Replacement products only available from pharmacies, and the cost included the weekly monitoring. If I had not been in ketosis at the weekly appointment I would not have been allowed to purchse the supply of meal replacements for the following week. A valuable safeguard, in my opinion.
Is it possible that in your determination (which is commendable) to resolve your blood glucose elevated levels, that you have rushed into ND without fully considering all the pros and cons? If you cannot get suppirt from GP, can you find it from a pharmacy, or perhaps a referral to a weigh management clinic? Not sure if you are eligible for NHS, but there are services available to help. We just have to search and find them.
Best of luck.

Edit: forgot to mention products from pharmacy were Lipotrim. (Others are available from supermarkets etc, much cheaper, but the cost of the Lipotrim included the pharmacy monitoring).

@Andrew Colvin is quite the expert on ND using real foods, and has achieved apparent 'reversal' of T2

 

[zand]

@wenlock00 I asked my GP about the Newcastle diet last year. He said I could do it but he couldn't supply the meal replacements for me (even if I paid for them myself). The Optifast meal replacements were only available on prescription in UK at the time. I asked if he would monitor me, he said it wasn't necessary. So yes, we do all get different levels of care even though we are all under the same NHS.

 

[AndBreathe]

@Daibell - I appreciate you are perfectly at liberty to give your opinion, but you make a bold and definitive statement about the Newcastle Diet.: "The ND isn't the ideal diet approach for diabetics as it focusses on calorie reduction rather than carb reduction". Whilst I would agree it isn't a long term approach, I do believe it can provide a decent springboard to improving a newly diagnosed T2's overall health lot. The documented evidence suggests that reducing the visceral fat levels, particularly in the liver and pancreatic regions can have a seismic impact on the body function, in terms of abnormal/normo-glycaemia.

I have no idea what the OP's plans are post-ND, as the wider discussion didn't take place, but there are people out there, like @Pipp , @Andrew Colvin , @paulins and an number of others who have benefited significantly from the approach. Whilst Andrew and paulins are relatively recent completers, Pipp had been post-ND for some years and has as yet, to the best of my knowledge slipped back into the diabetic arena.

 

[Pipp]

@Diabell - I appreciate you are perfectly at liberty to give your opinion, but you make a bold and definitive statement about the Newcastle Diet.: "The ND isn't the ideal diet approach for diabetics as it focusses on calorie reduction rather than carb reduction". Whilst I would agree it isn't a long term approach, I do believe it can provide a decent springboard to improving a newly diagnosed T2's overall health lot. The documented evidence suggests that reducing the visceral fat levels, particularly in the liver and pancreatic regions can have a seismic impact on the body function, in terms of abnormal/normo-glycaemia.

I have no idea what the OP's plans are post-ND, as the wider discussion didn't take place, but there are people out there, like @Pipp , @Andrew Colvin , @paulins and an number of others who have benefited significantly from the approach. Whilst Andrew and paulins are relatively recent completers, Pipp had been post-ND for some years and has as yet, to the best of my knowledge slipped back into the diabetic arena.

To add to @AndBreathe 's previous post...
I would always say ND is not a quick fix, or long term diet. Better described as short term immediate intervention suitable for some T2s, to reduce visceral fat and bring stability to BG levels.
When and if this is achieved a permanent way of eating to maintain the improvement is essential. For me, and I believe all post ND, that has to be to consume less carbs. For that we all need to find the individual optimum level our bodies can cope with. I know of no other way of determining that than to monitor BG regularly and keep an eye on weight, and adjust diet accordingly.

 

[zand]

When discussing the ND I think we should always remember that it was devised as a plan to use instead of bariatric surgery. Even after surgery the patients would have to adhere to a strict diet, so naturally after the ND they will have to eat healthily too. The ND has to be a much better way of tackling weight loss than bariatric surgery and it has been proved to work.

 

[phoenix]

Stomach problems are a symptom of DKA but from personal experience you don't always feel dreadful. I was sent to the hospital and didn't understand because of language problems that it meant now , didn't rush and had a coffee on the way. Still had DKA.
On the other hand a Ph of 8 is alkaline; not acidic so suggests not DKA . What we don't know is if the strip was read accurately, at exactly the right time,(30sec or 1 minute etc) This very important with urine strips
If you feel unwell then you really need to talk to someone who can assess at first hand ie a local doctor.

 

[wenlock00]

Stomach problems are a symptom of DKA but from personal experience you don't always feel dreadful. I was sent to the hospital and didn't understand because of language problems that it meant now , didn't rush and had a coffee on the way. Still had DKA.
On the other hand a Ph of 8 is alkaline; not acidic so suggests not DKA. What we don't know is if the strip was read accurately, at exactly the right time,(30sec or 1 minute etc) This very important with urine strips
If you feel unwell then you really need to talk to someone who can assess at first hand ie a local doctor.

Hi phoenix - well spotted !! and my most greatfull thanks for that.

I noticed the PH was to the far right of the canister chart and assumed it was acidic, It is definitely marked with an 8.0 and it is a sort of dark green. So I have definitely misread this. Do I have another problem with it being so alkaline (LOL).

I think my problem then is probably definitely 'Ketosis Flu' - so I need to ensure enough salt and electrolites, perhaps the extra shake and see if I start to feel better. When I read the PH thing on the testing leaflet, because I had made the wrong reading it made me panic.

I know I have made some wrong interpretations and silly mistakes on this thread, but it is a learning experience and I think that is a major part of what we/I are doing. I do not want a Doctor telling me stuff he probably learn't in medical school 20 years ago or some young buck parroting the NHS NICE guidelines at me. I would rather listen to the people on this forum who have real experience. So yes, I may stumble but on the bright side I am building experience and getting real information I can accept and understand.

If I had gone to the Doctor and told him what I initially thought, would he have double checked, I doubt it, they would probably just sent me away with a message to consume more carbs.

 

[phoenix]

I'd still say see a doctor if you are feeling unwell.
I didn't because I though I had T2 (self diagnosed) and was fine but I wasn't .Eleven years later I am fine, thanks to the doctor who diagnosed that I had Type
I do hope you see this

Edited much later still thinking about this
Please go to the doctor to check.

 

[ButtterflyLady]

Not trusting doctors is understandable if you have had bad experiences, and I have had some truly awful experiences with doctors at every level of medical care. But I work with them because I need to. I don't have a choice; my many medical conditions mean I have to see my GP about once every 4-6 weeks. A few years ago it was once every 2-3 weeks. If she says something like eat more carbs, I just smile and ignore the advice. I go in to get what I need, whether it's diagnosis, advice, drugs, or a referral. I can't get those things from laypeople.

 

[wenlock00]

Not trusting doctors is understandable if you have had bad experiences, and I have had some truly awful experiences with doctors at every level of medical care. But I work with them because I need to. I don't have a choice; my many medical conditions mean I have to see my GP about once every 4-6 weeks. A few years ago it was once every 2-3 weeks. If she says something like eat more carbs, I just smile and ignore the advice. I go in to get what I need, whether it's diagnosis, advice, drugs, or a referral. I can't get those things from laypeople.

Hi CatLadyNZ

I found the GP practice I went to in Wellington, NZ for 2 years a million miles better to the one I attend in the UK (and the UK GP Practice I attend is one of the better ones in our area, some of them are totally unsafe as are the hospitals).

I have found out what I need to know from this article.

I am an intelligent person, we all make mistakes, both Doctors and ourselves. I am afraid the NHS has totally lost my trust.

One thing a NHS GP once said to me was that I am responsible for my own health and I am very happy with that.

Phoenix, Brunneria and AndBreathe have provided just that little bit of council and insight I needed to get back in the right direction.