Trying to understand...

Hi again, as a rather obese 48 year old sedentary woman (back issues, hypermobile joints, and a lifetime of RH which contributed massively (pun!) to the obesity), I am not the best person to advise on exercise.

BUT

I can tell you that the last 2 years on a ketogenic diet (much less than 50g carbs a day and fuelled by fat) I am fitter, slimmer and more active than I have been in 20 years. The ketosis gives me more energy, more stamina and better mental clarity than I ever had on carb-as-fuel.

If you are interested, have a look for a book by Volleck and Phinney 'The art and science of low carb'. There is one on general low carb living, and one on being an athlete. That should give you everything you need to know, including managing electrolytes and endurance stuff.

The general rule is that low carb is good for endurance and carbs are good for short term bursts. But having said that, my body does so much better on low carb, that I am better on BOTH than I was on carbs.

That's a woman's area, someone help!

@Brunneria will probably know!

Now that, I am afraid, is something I know nothing about at all!

Personally, I would prefer to feel well during my pregnancy, rather than as half dead as I do on carbs. I cannot believe that subjecting a baby to constantly fluctuating insulin and sugar levels is a good thing, but as I say, that is gut feeling, not based on any actual knowledge.

Have you ever been in ketosis, and tested your ketone levels?
As Volleck and Phinney explain superbly, there is a huge difference between 'nutritional' ketosis and ketoacidosis. The latter is incredibly harmful and only arises when there is no insulin present and blood glucose goes crazy high. It is very dangerous. but only happens to Type 1 diabetics and type 2s on insulin. The nutritional ketosis is a whole different ball game. It involved small amounts of ketones that circulate the blood acting as fuel. Once the body adapts and expects to run on ketones (like mine) then they become the preferred fuel.
I cannot believe that the ketone levels present in nutritional ketosis would be harmful.

However, if you go to an ordinary doctor and ask them this question, you will probably see them go blank and default to ketones-are-bad, because most of them have never heard of anything except ketoacidosis, and therefore think you will kill yourslef and your baby with such insane behaviour. OK, that was probably a bit of an exaggeration, but you get my drift.

Maybe get the V and Ph book, have a good long read. a longer think, and then see if either of the authors have a website or blog. if so, go there and ask your question.

But I am pretty sure you will be in a better, healthier, position to house a baby, if your blood glucose is steady, than if you are having RH type swings all the time, so low carb would work, but whether being very low carb, and being in ketosis is a good idea... you definitely need an expert opinion - but choose your expert wisely!

Think that's a great answer Brun.
Fluctuating blood glucose levels are what causes the symptoms, so adding carbs, for baby, wouldn't help. You have to be healthy for the baby to be healthy and for RH ers, that means in control and probably in ketosis, let your body look after you!

I always say to people that I'm allergic to carbs, as its the easy answer than going on about reacting to things that spike you!

How is the GERD going? Are you on meds for it? Have you had an upper endoscopy?

court10 said:

Great question @CatLadyNZ because I'm struggling right now after a big lunch of protein and fat. It's weird because a majority of my pain comes from behind my navel and goes straight up. I get chest pain and all. Someone gave me HCL tabs to try to today. I think they helped the reflux but still hurting in the navel area and radiates into my chest. Makes me feel pretty unwell I must say. That's where I'm struggling, trying to figure out what symptoms are blood sugars and what are GI. I was popping zantac but it only helps for so long. Maybe I should be on a PPI but I have kinda avoided starting on one again. Might need it. I just don't understand why it's behind my navel that makes me so sick, that's not really my stomach.

The endoscopy showed hiatal hernia and gastritis. I also still have food in my stomach after fasting overnight. I did eat a ton of chicken the night before and I remember my blood sugars being messed up that day.

Do you have GERD? Any symptoms behind the navel? Meds that work?

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Yes, I have GERD and delayed gastric emptying and I'm on omeprazole, domperidone, ranitidine, and ondansetron (if needed).

In my experience pain behind the navel comes from the colon and was related to constipation. It sounds like you could have delayed gastric emptying and possibly slow colonic transit? There are tests you can have for these, through a gastroenterologist. Your endoscopy showing retained food is probably diagnostic for delayed gastric emptying. Drugs can help -unfortunately, domperidone is not available in the UK but metoclopramide is used instead.

What are HCL tablets? Constipation worsens my upper GI symptoms. One thing a doctor once said was that I could have a grumbling appendix, but I think he was grabbing at straws. Appendix pain can be referred to the navel, but so can any colonic pain.

court10 said:

Yes, totally get that. I think I have gastroparesis. Was diagnosed with it a very long time ago but kinda haven't given it any significance. Funny thing is doc wants me to do a gastric emptying test. I was going to put it off because of having to eat bread with jelly, and eggs. Should I do it?

What diet do you do for gastroparesis? Does high felt help or hurt it? I'm struggling with this piece and managing blood sugars.

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@donnellysdogs did a 'shapes' test for gastric emptying. Said it was very helpful.

They must have other options than bread, mustn't they? Coeliacs must have other choices...

court10 said:

Yes, totally get that. I think I have gastroparesis. Was diagnosed with it a very long time ago but kinda haven't given it any significance. Funny thing is doc wants me to do a gastric emptying test. I was going to put it off because of having to eat bread with jelly, and eggs. Should I do it?

What diet do you do for gastroparesis? Does high felt help or hurt it? I'm struggling with this piece and managing blood sugars.

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There are a couple of good threads on gastroparesis that you can find by doing a search. I don't have full blown GP, just delayed stomach emptying, which is not as severe. I find domperidone controls it for me, and reducing constipation. The gastric emptying test is not very reliable, because GP varies from day to day. There is info about that here:

court10 said:

PS HCL tablets are supposed to help with digestion if you have less acid.

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But what are they? What does HCL stand for?

court10 said:

Hydrochloric Acid. I thought they'd cause burning but actually helped with the reflux.

Do you have blood sugar issues and delayed stomach emptying? Do you find high fiber plus fat is good. Maybe high protein stops me up too much.

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Fortunately the DGE doesn't mess with my blood sugars, but I understand GP does, for T1s. Yes I try to eat high fibre and enough fats to replace carbs and give me energy and satiety. High protein is not good for the kidneys.

If you have upper GI motility issues then you almost certainly have lower GI motility issues. I have to work very hard to keep my colon moving. I take psyllium (metamucil), laxsol, lactulose and lax-sachets, and I'm only just keeping my head above water, so to speak. I'd encourage you to ask your doctor about meds for constipation, which may reduce your navel pain and reflux, and help your stomach work better.

I'm afraid i know nothing about c-peptide.

Have you seen the LADA section on the forum? They are great at answering questions over there.

Have you recently cut your carbs severely?
Sometimes when they do that abruptly, people feel pretty dreadful - it is known as 'carb flu'.

Brunneria said:

Hi again, as a rather obese 48 year old sedentary woman (back issues, hypermobile joints, and a lifetime of RH which contributed massively (pun!) to the obesity), I am not the best person to advise on exercise.

BUT

I can tell you that the last 2 years on a ketogenic diet (much less than 50g carbs a day and fuelled by fat) I am fitter, slimmer and more active than I have been in 20 years. The ketosis gives me more energy, more stamina and better mental clarity than I ever had on carb-as-fuel.

If you are interested, have a look for a book by Volleck and Phinney 'The art and science of low carb'. There is one on general low carb living, and one on being an athlete. That should give you everything you need to know, including managing electrolytes and endurance stuff.

The general rule is that low carb is good for endurance and carbs are good for short term bursts. But having said that, my body does so much better on low carb, that I am better on BOTH than I was on carbs.

Click to expand...

Hi Brunneria, you mention hyper mobile joints in your post above. I have recently been diagnosed with sudden onset hyper mobile joints and no one is able to give me a reason for it. I started off with pain in my muscles, pins and needles and a burning sensation in both my hands back in 2011. At that time there was no hyper mobility in any of my joints. Now I have sublaxation in both my thumb joints elbows wrists and ankles I'm in constant pain because all my joints move beyond the normal range and are not supported by my ligaments and tendons. The pain has improved significantly since I started a low carb diet and if I do eat carbs the pain comes back with a vengeance!

Can I ask if you've always had hyper mobile joints and if not what have you been told is the cause? Sorry to be nosey but I am desparate to learn as much as possible.