Perceived risks of low carb diets - dehydration

I have only just started testing for ketones because I was concerned about losing too much weight (seemed to have stopped losing now according to the strips anyway and my scales). But while I was losing weight on low carb I had no problems with dehydration. I had read early on in the forum about salt levels so that wasn't a problem. No frequency with toileting or cotton wool mouth at all. Hmmm, an interesting one.

Years ago I saw a repeat of the TV programme Quincy. In it a young girl had died of dehydration and kidney failure because she had done a low carb, high protein, no fluids diet (even stricter than the original Atkins). Whist I realise this was simply a fictional programme I think many people still think of low carb as meaning high protein too.

Hi @LittleGreyCat ,

I can only surmise that your HCP with the confusion between DKA & The ketogenic diet, has pinned the "dehydration" symptom to the wrong one...?

Hi @LittleGreyCat ..
I follow an LCHF lifestyle with 16.8 intermittent fasting. I have had no problems with dehydration .. probably because I drink 5 or 6 x 500ml bottles of carbonated spring water every day

I think the key thing is that these are 'perceived' risks.

All my life, if I didn't drink enough, I got a headache. Then I had a big glass of water, and the headache disappeared.
(I saw a brilliant documentary years ago that pointed out most people take a painkiller for headaches, but usually the water they use to swallow the pill is more effective than the tablet. )

Anyway, now I low carb, and the same thing happens - I don't drink enough > headache > I drink more > headache disappears.

I don't blame LC for that, I blame myself for not drinking enough.

As for the ketoacidosis confusion... I kind of take the view that anyone who confuses ketoacidosis with nutritional ketosis is not somebody who should be giving out advice on the subject because they are obviously too ignorant for that advice to be trusted.

Now, if that doc had mentioned electrolyte imbalance as a perceived risk, I would be nodding away.
https://www.dietdoctor.com/low-carb/keto/supplements

Edited to change the link.

LittleGreyCat said:

Anyone had major dehydration problems?

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I had a kidney stone two months after going on a low-carb/more-exercise routine as a result of T2 diagnosis earlier this year. The doctors/nurses treating me said I was probably dehydrated as a result of not drinking enough fluids during exercise, and that this probably helped cause the kidney stone. Since then I have made sure to drink at least 1.5 to 2 liters of water per day, mostly during exercise.

There are all sorts of reasons why you can become dehydrated, and (at least in my case) no reason to believe that it is connected to the low-carb diet. I am now drinking a lot more fluids than I was, pre-diagnosis, and that is probably a good thing in its own right: something I should have been doing even without the T2 diagnosis.

Grateful said:

I had a kidney stone two months after going on a low-carb/more-exercise routine as a result of T2 diagnosis earlier this year. The doctors/nurses treating me said I was probably dehydrated as a result of not drinking enough fluids during exercise, and that this probably helped cause the kidney stone.

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Well at least they didn't blame the diet...
According to Dr Google it can take anywhere from 3 months to years to grow a kidney stone so you may well have been well on the way to getting it before changing anything.. I am happy to be proved wrong but that seems to be what a cursory look says.

Now, this does surprise me because we all eat tons of salads and veg. There is water in these foods. I would have thought that we are getting more liquid than on a high carb diet. I know that I do not drink enough water but that is because I am not thirsty. I wondered if this was due to eating so much salad.

I had kidney stones after DX as well but I was eating loads of spinach everyday. And nuts and other dark leafy greens so I blame them. I've been VLC for over 25+ years. Low carb is dehydrating by nature which is why when people start it they lose loads of water weight in the first few weeks.

Now I try to eat a low oxylate diet to stop the growth of the other two small stones I have in my other kidney. I don't drink as much water as I should but I try. Adding lemon juice helps me drink a bit more.

bulkbiker said:

Well at least they didn't blame the diet...
According to Dr Google it can take anywhere from 3 months to years to grow a kidney stone so you may well have been well on the way to getting it before changing anything.. I am happy to be proved wrong but that seems to be what a cursory look says.

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Makes sense. By the way, once you've had a kidney stone you get very motivated to avoid another one! The pain has been described as "worse than childbirth" although, being male, I cannot make a direct personal comparison! After I had "passed" the stone, the kidney specialist plugged my numbers into his "stone prediction" software and said my chance of having another one in the next 10 years is about 19 percent. (But of course, that is for "average" patients including those who make no lifestyle changes after passing the stone.)

The downside of increased hydration is that it is actually quite hard to drink 2 liters of water per day (in addition to drinking during meals). Plus you make a lot more trips to the toilet, but that was already something I had got used to during several years as an un-diagnosed diabetic.

I wanted to add one more thing that puzzles me about what the nurse told the OP. A typical low-carb diet includes quite a lot of high-water foods, such as salads and vegetables. Lettuce is something like 96 percent water! Cauliflower is 91 percent! Now, if the nurse had said low-carb can contribute to, for instance, constipation, she would have been on surer ground.

Grateful said:

I wanted to add one more thing that puzzles me about what the nurse told the OP. A typical low-carb diet includes quite a lot of high-water foods, such as salads and vegetables. Lettuce is something like 96 percent water! Cauliflower is 91 percent! Now, if the nurse had said low-carb can contribute to, for instance, constipation, she would have been on surer ground.

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I think that's maybe why we shouldn't take nutritional advice from nurses?

I drink a lot of water and tea, but I was doing before I was diagnosed. I seem to be surgically attached to a bottle of water and take sips of it all the time. I don't glug it down as that does put a strain on the kidneys. I became aware of the need to drink a lot when I was on cancer treatment, which as you may know involves pouring nasty chemicals and biological stuff directly into your veins, all of which affect kidney function. The oncologists said over and over ... drink, drink, drink. It became a habit, and I just carried on. I have no problems with hydration. I think I am now addicted to water!!

Bluetit1802 said:

I drink a lot of water and tea, but I was doing before I was diagnosed. I seem to be surgically attached to a bottle of water and take sips of it all the time. I don't glug it down as that does put a strain on the kidneys. I became aware of the need to drink a lot when I was on cancer treatment, which as you may know involves pouring nasty chemicals and biological stuff directly into your veins, all of which affect kidney function. The oncologists said over and over ... drink, drink, drink. It became a habit, and I just carried on. I have no problems with hydration. I think I am now addicted to water!!

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I have to limit myself to one nespresso or I'll just drink coffee all day. If I don't have coffee I'll drink seltzer with lemon. I too sip all day never guzzle. My hubby guzzles 2 pints before he goes to bed. Lordy Lordy I'd be so bloated!!

Zand said:

Years ago I saw a repeat of the TV programme Quincy. In it a young girl had died of dehydration and kidney failure because she had done a low carb, high protein, no fluids diet (even stricter than the original Atkins). Whist I realise this was simply a fictional programme I think many people still think of low carb as meaning high protein too.

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My dietician has asked me to increase my protein. Maybe because of wobby weak legs. I have lost muscle as well as fat. Just increased a little to see what difference it makes. Not high protein diet. Low carb, lowish fat. Will keep you updated.
I love Quincy and his autopsies. he really cheers me up. Ha ha

No hydration nor dangerous ketones but bad palpitations. Palpitations is listed as a possible side affect of the low carb programme diet.
Water drinking is also advised.
Posters heavily advise salt to replace processed food (full of it).
Over the years of controlled diabetes in the early stages of diagnosis I always had higher blood pressure when I had good control. Don't ask me why.
Same happened on lchf my blood pressure raised and I had good bgs. I ended up on more meds for high blood pressure control. Maybe palpitations due to high blood pressure on atherosclerosis? Not sure but chest pains due to fast heart beat and palpitations controlled by betablockers now.
Low carb has reduced my weight via less insulin needed. One benefit I wanted to keep.