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I have proteinuria, am I eating too much protein?

ChrisMaleType1

ChrisMaleType1

Well-Known Member
Messages
115
Location
North West England
Type of diabetes
Type 1
Treatment type
Insulin
Hi everyone. I hope you're all doing well.

I started a low-carb ala Dr Bernstein diet late 2019. I'm quite slim, I weigh about 57 kg, I exercise occasionally.

I've had some proteinuria almost since the time I was diagnosed with type 1 in 2007, though it has usually been kept at bay. My previous consultant blames himself for it getting worse because he didn't put me on an ace inhibitor, for it's renoprotective as well as it's antihyperintensive qualities, quickly enough.

My last urea result was 9.4 mmol/l. It has been a bit high now almost consistently for 15 months (please see picture below).

I started the low carb diet eating about 135 g of protein per day but I was losing weight so I'm now eating 165-180 g a day. Should I reduce the protein? If so, should I increase the fat and does fat give the body energy? Or should I increase the carbs? I go through phases of eating dairy. I think my high urea results started a bit before began the low-carb diet but could the diet be making my kidneys work too hard?

Here's a picture of my urea test results:
 
Last edited by a moderator:
Hi sorry I am not able to help but in replying it would put your post back at the top and hopefully someone more knowledgeable will come along soon. Take care
 
I'm not at all qualified to answer your question since I'm a Type 2 - I doubt that anybody except your consultant is.
But this may help:
How many calories per day are you currently consuming?
How much of them come from Fats?

165gms of protein per day seems like more than absolutely required for a 57Kg male, but isn't outrageous since many carnivores consume more than that.
You have to find a balance of Proteins and healthy (traditional) Fats that suit your own particular body and tastes.
Increasing Fat is unlikely to harm you. The main reason for Low Carb people limiting Fat is because they are trying to lose weight, though I lost weight without trying even with eating more calories (most of them from increased Fats) than before I went Low Carb.
 
ianf0ster said:
I'm not at all qualified to answer your question since I'm a Type 2 - I doubt that anybody except your consultant is.
But this may help:
How many calories per day are you currently consuming?
How much of them come from Fats?
Click to expand...

Hi, sorry for the late reply. Thanks for the reply. I'm not sure how many calories I have, obviously it's enough to maintain my weight though which doesn't fluctuate very much. The amount of fat I eat has increased a bit recently, it's probably pointless putting a percentage on it. Protein is definitely my main source of energy. I've got a coronary artery test coming up.

My question was really about protein levels given that I have some damage to my kidneys. I hope to speak to my consultant who hopefully will have an answer to my question. He's put me on the highest dose, 10 mg, of Ramipril an ace-inhibitor so he's treating it seriously. Unfortunately though I don't think he's got much experience with low-carb/high-protein diets.

Can anyone recommend a private GP or consultant in London or the UK who's very experienced with low-carb/high protein diets and diabetes?
 
Are your kidneys actually damaged, as the label proteinuria is indicates protein leaking out of the kidneys, this is different to high levels of protein due to consumption and no damage.

The AMDR is 10–35% of caloric intake as protein (Acceptable Macronutrient Distribution Range), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347101/ this is often forgotten, with the lowest level of 10% to stay alive being cited. It is so unfortunate that protein has been sidelined when if this is preferenced good things happen.

The upper limit on patient access is 7.8, mine is 8.4 and has been higher. The ranges are reference ranges based on averages.....of people eating the standard societal diets which tend to be circa 60% plant based high carb. Just as with Keto / Carnivore diets other items such as LDL goes up in around 33%, the bottom line is are you healthy.

What is your GFR (cystatin-C is great if you can get this when meat based http://www.diabetesincontrol.com/testing-kidney-function-using-an-alternative-filtration-marker/). If your eGFR is high (lowest normal 60) then higher urea levels may not indicate kidney issues (mine 67, this time last year 68 (diabetes damaged my kidneys and high protein has made it no worse).

On Bernsteins protocol, I would try and contact him as a long standing Type 1, failing that someone like Dr Paul Mason, in the UK Dr David Unwin or Dr Trudi Deakin; it has to be meaningful to seek the opinion of those with clinical practices.

This is my urea graph:
upload_2021-3-3_21-33-49.png

I suspected animal based dieting creates the results you and I have seen:
A quick Google shows:
upload_2021-3-3_21-51-12.png

As this is a measurement outside of the norm, it is inappropriate to state definitives. It would be useful for other high protein / carnivores to chime in if they have numbers. I am not worried, as I am seeing nothing going on with my kidneys despite high meat and fish.
 
I should probably be ignored , I have no idea what I’m talking about... I’m following along as I’ve been eating crazy amounts of protein since I started weight training.

Whats your BMI? I wonder if you’re burning up your lean mass
 
LaoDan said:
I should probably be ignored , I have no idea what I’m talking about... I’m following along as I’ve been eating crazy amounts of protein since I started weight training.

Whats your BMI? I wonder if you’re burning up your lean mass
Click to expand...

Hi. I don't pay much attention to BMI I'm afraid I believe it's too generalised.
 
ChrisMaleType1 said:
Hi. I don't pay much attention to BMI I'm afraid I believe it's too generalised.
Click to expand...

True, I’m was just wondering about body fat percentage, the weight you mentioned could be considered very low depending on your height. I’m probably wrong but I hope you’re not starving yourself. Imho if you’re below 8% , that could be a problem
 
Mbaker said:
Are your kidneys actually damaged, as the label proteinuria is indicates protein leaking out of the kidneys, this is different to high levels of protein due to consumption and no damage.
Click to expand...

Thanks for the full reply! Yes unfortunately my recent urea result is 9.1 My estimated GFR is 66 which from you say is on the low side of normal (a bit worse than yours). However, patientaccess puts this in red and says the number should be greater than 89. My urea numbers have been consistently high since October 2019. My eGFR has been high recently and most through October 2019 and 2020.

Here are my graphs:

 
LaoDan said:
True, I’m was just wondering about body fat percentage, the weight you mentioned could be considered very low depending on your height. I’m probably wrong but I hope you’re not starving yourself. Imho if you’re below 8% , that could be a problem
Click to expand...

Thanks, sorry I misunderstood. Yes it's possible I'm a little bit underweight at the moment.

Edit. I'll watch that.
 
Most T2s I know who go low carb aim to increase fats rather than protein if they lose too much weight. Unless this is also an health issue for you then maybe up your fat intake, as going low carb means you will burning fat instead of sugars?
Simple tips are to have oily dressings on salads, eat egg and cheese, use ground almonds or coconut flour instead of flour in cooking, have full fat milk or double cream.
 
TriciaWs said:
Most T2s I know who go low carb aim to increase fats rather than protein if they lose too much weight. Unless this is also an health issue for you then maybe up your fat intake, as going low carb means you will burning fat instead of sugars?
Simple tips are to have oily dressings on salads, eat egg and cheese, use ground almonds or coconut flour instead of flour in cooking, have full fat milk or double cream.
Click to expand...
That's music to my ears you know! Yes I have oily dressing, lots of mayonnaise, and cheese. I'm off nuts at the moment but I plan to go back to them and double cream as well. I got some 'high' cholesterol readings last year so I panicked and reduced my fat intake. I know, that was probably a bit silly. I wanted to get a coronary artery test and I've got that coming up this month.
 
ChrisMaleType1 said:
Thanks for the full reply! Yes unfortunately my recent urea result is 9.1 My estimated GFR is 66 which from you say is on the low side of normal (a bit worse than yours). However, patientaccess puts this in red and says the number should be greater than 89. My urea numbers have been consistently high since October 2019. My eGFR has been high recently and most through October 2019 and 2020.

Here are my graphs:

Click to expand...

As you are lean, why not consider balancing out the energy incrementally, maybe take the protein down to 135 again which is close to the 1g per pound of body weight Ted Naiman recommends, and filling out the gap with quality fat and or low gi carbs, to hold onto muscle lift heavy. I would then ask for at least 2 tests 3 months apart at your surgery

Maybe for oldies like me the range is different for eGFR, but I can't find the reference, but do know eating alot of meat makes this not as reliable due to another measurement (again can't remember which changes the estimate); this is why cystatin-C if available is a better test in this context (I can reference Dr Shawn Baker on this point).

I use eGFR to more so measure variance so my last 3 have been 68, 69 and 67, which considering pummelling meat, fish and dairy I am happy with. You look alot younger than me, so perhaps er on the side of caution, and pull back from the 1.44 g per pound of bodyweight, as this is close to the 1.6 some say is top end for body builders. I look at my kidney function before A1c as this you cannot mess around with too much.
 
Mbaker said:
As you are lean, why not consider balancing out the energy incrementally, maybe take the protein down to 135 again which is close to the 1g per pound of body weight Ted Naiman recommends, and filling out the gap with quality fat and or low gi carbs, to hold onto muscle lift heavy. I would then ask for at least 2 tests 3 months apart at your surgery... You look alot younger than me, so perhaps er on the side of caution, and pull back from the 1.44 g per pound of bodyweight, as this is close to the 1.6 some say is top end for body builders. I look at my kidney function before A1c as this you cannot mess around with too much.
Click to expand...

Haha. I expect you look younger than me, I'm actually 41 and this photo was taken a few years ago. I am still young.

I think you're right I should err on the side of caution. Before I went low carb I ate a low gi diet. I don't really want to increase carbohydrates. I'll increase quality fat for the moment and reduce my protein. I was tested a couple of weeks ago so I'll get tested 3 months from now and see what's happening.

Out of interest, have you had a cystatin-C test yourself and was it done privately or on the NHS? I don't think I meet their criteria though I may ask for it in the future.
 
ChrisMaleType1 said:
Haha. I expect you look younger than me, I'm actually 41 and this photo was taken a few years ago. I am still young.

I think you're right I should err on the side of caution. Before I went low carb I ate a low gi diet. I don't really want to increase carbohydrates. I'll increase quality fat for the moment and reduce my protein. I was tested a couple of weeks ago so I'll get tested 3 months from now and see what's happening.

Out of interest, have you had a cystatin-C test yourself and was it done privately or on the NHS? I don't think I meet their criteria though I may ask for it in the future.
Click to expand...
I haven't had the test, as I am satisfied with the stability over the years; I had a major dip on Metformin which should not have been prescribed to me, but since then fine by my standards.

Don't blame you on the fat over carbs.

I'm about to have some major private tests by Medichecks, but they do not do the test, as I always do after my NHS tests. https://labtestsonline.org.uk/tests/cystatin-c perform the test in the UK.
 
Hi @ChrisMaleType1 I can’t answer your question, but there’s an Aussie Engineer married to someone with T1 who writes about nutrition and exercise at https://optimisingnutrition.com

He promotes his books etc. but his weekly email gives detailed advice and I think some of it may help you. I don’t know to what extent he can give personal help (and he’s not a doctor).
 
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