Underweight and LCHF?

I have zero issues gaining weight on a low-carb diet, but my approach is a bit less conventional than most. I have a very high protein intake (200g-250g on most days) which I regulate depending on if I want to lose or gain weight. It wouldn't be a good approach for someone with kidney damage, but there is no (conclusive) evidence to show that a high protein diet is dangerous to a healthy kidney.

If you are MODY or LADA chances are your not going to gain weight no matter what or how much you eat. If that is the case you will need insulin to gain. Sudden severe weight loss is an indication you may be one of those.

Have you recently lost weight @clingclang ? Or have you always been very slim?

Do you test your blood sugar?

@clingclang That's quite a weight loss if you're only light to start with.

I have Type 1 not suspected MODY but I lost a lot of weight when I was diagnosed due to high sugars. I understand there are different types of MODY which require different treatments. If it was me, I'd be tempted to buy some strips or see if the doctor would prescribe some, but that's just me. That way you could see what your blood sugar was doing after certain foods eg if you ate carbs, and check if your sugars are high.

clingclang said:

I have run out of test strips and currently can't afford to replace them, or the meter as I'm not sure it was working correctly.

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Where are you based? Are you on any medication for your diabetes?

Hi. It looks like you are a LADA or possibly MODY etc. You do need to be on some medication. Are you testing with a meter? At that BMI I would suspect you may need to be on insulin at a future point. Use the meter to guide you as end June is along time away. When low-carbing, having enough protein, fats, veg and non-tropical fruit should ensure you are having all the nutrients you need but losing weight implies that your insulin is going down and you body may be burning fat for energy. OK as long as your blood sugar doesn't go up at the same time.

I'm not a doctor but that doesn't sound ideal to me - you have been diagnosed with diabetes and sent home with absolutely nothing. What were your blood sugars like when you were testing? I would guess that your weight loss is caused by untreated diabetes and I would either be returning to the GP and asking for a prescription for test strip & metre and an expidited referral to endocrinology, if your GP has already referred you to endocrinology and you are waiting for the appointment you could try to find the number for the diabetic specialist nurses at your local hospital an call them for advice. Or, go to a local pharmacy that offers free diabetic tests (a big boots or lloyds) and ask them to check your blood sugar - if it's in double figures, I'd be going to A&E because you have no way of managing your sugar or checking for ketones which can be dangerous and you need to get seen and treated.

If I was you I would go extreme LCHF straight away, if your pancreas is still producing some insulin it may be enough to straighten you out in the short term. Dr Bernstein talks about strict carb restriction inducing or maintaining 'the honeymoon period preserving the insulin secretion that you do have. If you add sufficient fat it should halt your weight loss.
The type of food I mean is
Breakfast - bacon egg and mushrooms, fried in a little lard or butter, not grilled
Or smoked salmon and scrambled eggs, scrambled with butter
Or an omelette, ham and cheese,say, again cooked in butter

Lunch - any meat, fish, eggs, cheese with a green salad dressed with oil and vinegar dressing or full fat Mayo (avoid everything low fat, it has extra carbs

Dinner - any meat fish eggs cheese cooked in any way, not breaded. Any sauce made with double cream, I use lemon zest and rind, added to pan juices, then big glob of cream, or chopped mushrooms, or chopped shallots, or mixed herbs or parsley) any green leafy veg, cauliflower cheese (use a cheese spread like seriously strong microwaved with a bit of double cream for a delicious, low carb, calorie rich sauce.

The Co-op have 2 big cartons of double cream for £2 at the moment.

When doing tight LCHF you will need to increase your salt intake (try to get hold of natural, unbleached, unrefined sea salt, I think Holland and Barrett have it or Himalayan, you can get that at LIDL I think), and plenty of water. If not you might experience 'Low Carb Flu' headache, general feeling of malaise. If you start to feel unwell, I would ring up and ask for an earlier appointment or go to A&E. You can't mess with diabetic Ketoacidosis, but if you have some insulin production, extreme LCHF should be a massive help.

just noticed your love of pasta, can't edit my last post for some reason. A good alternative to pasta is white cabbage, I either finely shred it or more thickly (like tagliatelle width) and cook quickly in a frying pan with a good knob of butter and a few drops of water. Serve while it still has some 'bite' with any old cream based pasta sauce, or ragu type but be a bit lighter on the tomatoes. Courgettes work well either shredded, thinly sliced or thickly sliced in things like lasagne (I dry them off in the oven first or the whole thing is a bit sloppy) - or aubergine and go down the moussaka route.

For a full list of 'eat freely' low carb foods, visit Tim Noakes Real Meal Revolution Green List

http://realmealrevolution.com/real-food-lists

@clingclang you are an untreated diabetic losing weight without trying, which suggests that you are possibly also producing ketones, which would be dangerous if allowed to progress to DKA. You top priority should be getting checked for ketones, ideally by getting yourself in front of a doctor. If you think staging a sit in at your GP or going to A&E would be overreacting, you can buy ketostix over the counter for about £6, but if they show ketones go to A&E.

Information on ketones - https://www.diabetes.org.uk/Guide-to-diabetes/Complications/Diabetic_Ketoacidosis/

clingclang said:

@catapillar My blood sugar was usually between 8 and 11, but I'm not sure the meter always worked correctly as often it would say 3.6 or low, so I would try again and it would give a completely different number so I am unsure on specific numbers. I will look into buying a ketostix, I did go back to the doctors last week (for an unrelated issue) and mentioned the weight loss and that I'm still experiencing extreme thirst. The doctor didn't seem too concerned and ordered another hba1c which I had on Monday and just awaiting the results. Going to the doctors concerns me because they so far have not been particularly supportive and I don't feel I can ask any questions, often feeling like I'm wasting their time!

@AtkinsMo Thank you for the food suggestions and advice, I will have to try some

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Hi. If strips are expensive for you then look on eBay. Many of these are ex-prescription so you need to decide about the ethics but if you have a genuine need then it's an option. BTW those number don't sound too bad currently but try ketostix as well as the occasional 2hour test.

@clingclang I agree that the weight loss does sound potentially worrying and I'd be wanting that checked out if it was me.

If you're not happy speaking to your doctor, could you call the diabetes consultant's secretary and have a word with them? They may be able to bring your appointment forward or put you through to a diabetes nurse for advice on the phone.

Is there any reason why your doctor suspected MODY, eg family history?

If you do go ultra low carb and your blood glucose does drop suddenly, and it can, you need to check blood glucose as well as ketones to avoid panicking unnecessarily - if your blood glucose goes low then ketones are nothing to worry about. They are the body's naturL fuel, converted from fat we eat. If your blood glucose is high and you have no insulin in circulation your body will start to use your muscle store to convert to glucose, that is what causes a sudden weight loss and the risk of Ketoacidosis. Here is a good article that explains the difference between nutritional ketosis and Ketoacidosis, toward the end of the article.

http://foodmed.net/2016/04/18/noakes-the-idiots-guide-to-lchf-and-banting/

Ok @clingclang

Hopefully, the specialist will give you a more definite answer. The only reasons I asked were because of your weight loss and because it's not unheard of for adults to be misdiagnosed. Not that I'm in any way saying you've been misdiagnosed, but don't be palmed off and do try again to see if your appointment can be brought forward so you can get confirmation and some appropriate advice.

If you're ok about buying another meter, sometimes high street chemists have them on offer (I got a spare one for £7 a couple of years ago) and they come with some free strips. That might work out cheaper than buying a pack of strips, depending on what your current meter is.