Hey ladies. Maybe somebody can help me out! I am 15+5 and cut grains out of my diet a few weeks ago. I lost around 5 lbs, which my m/w said not to be concerned about. I started this pregnancy 20lbs over my normal weight anyway. Over the last several days I've been spilling small-moderate ketones and I've been having lots of headaches. I upped my food and carb (beans, fruit) intake and I've gained a bit of weight but I'm still spilling. I talked to my m/w tonight and she said I should eat rice daily if I'm consuming no other grains. I'd prefer not to, but if it is best for the baby I'll do it. Any advice?
Have you considered the possibility of gestational diabetes?
If OP is 15+5 and it's diabetes, it's pre-existing type 2, not gestational. Are you drinking lots of water, josie423? Ketones + h/a can be dehydration.
It's not unheard of to detect gestational diabetes in early pregnancy...http://care.diabetesjournals.org/content/14/4/288
This article http://care.diabetesjournals.org/content/33/3/676.long is quite a bit more recent. There's a relevant section toward the end titled "detection and diagnosis of overt diabetes during pregnancy". If diabetes is diagnosed for the first time during early pregnancy, by definition it's "gestational diabetes", but is likely (depending on mom's risk factors) to be pre-existing Type 2 DM that hadn't been diagnosed.
Thanks for the suggestions everyone! I don't think the issue is GD, and there is no pre-existing diabetes either (I'm 150 lbs and have no other risk factors). I thought over my food intake yesterday and realized I had very few carbs, so I'm sure that's it and a possibility of not drinking enough. Some days I do very well on water, some days not so well. Yesterday was so-so. I'm going to have some rice at lunch and eat more fruit as well. Hopefully that takes care of it! Oh, and is there any significance to the time of day I spill ketones? I am usually fine early on, but in the evening they are there.
This type of eating demands much more vigilance than I am used to, but I don't think that's a bad thing.
How much fluid are you getting in? I spill ketones in the afternoon if I have not drunk enough fluids during the day. The two big things I suggest are 1) add a complex carb to each meal and 2) up your fluid intake.
I try to get minimum of about half an ounce of water per pound of body weight, most days I get min. 70-80 ounces usually more. The first day I found I was spilling was after drinking close to 200 oz throughout the day. I'd had an awful headache since that morning and the water wasn't helping at all like it normally did, that's why I dipped a stick in the evening.
I checked this morning before eating breakfast and it was just trace (small-moderate last night)? I find that odd, I would think it would be even more than last night after not eating for a whole night.
Thank you! That makes a lot of sense. I had a big lunch and had some rice with it, and also a carb-y breakfast and no ketones this evening. It seems like a pretty simple fix (I hope!).
Hi, I had gestational diabetes and they made me test daily for ketones--apparently they can be really harmful to your kidlet (at least that's what they told me, I must admit that I never researched it). You may want to look into it.
I can tell you that I only ever once got ketones when I really, REALLY skimped the carbs I ate (like 70 g carbs on one particular day). With something like 90g carbs/day, all stuff like fruit, brown rice, sweet potatoes, steel-cut oats, etc., I didn't spill ketones.
I just wanted to chime in on the ketosis vs ketoacidosis explanations. I actually have type 1 diabetes, so I've heard about the dangers of ketoACIDOSIS all of my adult life - and yes, it can kill you. That said ... nutritional ketosis is a very different beast, and many researchers now actually seem to believe that it is a very healthy state to be in. As other posters have mentioned, ketones are formed by your body when you are using fat for energy instead of carbohydrates - so most people who don't eat very many carbohydrates will automatically produce ketones. That state of nutritional ketosis is characterized by a lack of hunger and stable energy and a clear mind. What happens in type 1 diabetics is very different: they will, like anyone else, also make ketones if they eat a low-carb diet (actually the optimal diet for diabetics). There are two other necessary conditions that make this safe and healthy nutritional ketosis turn into diabetic ketoacidosis (and these conditions CANNOT BOTH OCCUR in a non-diabetic): the diabetic is dehydrated for some reason (perhaps he or she has been sick with a stomach flu and vomiting, can't hold food down, for example), and he/she has very high blood sugar (meaning, conversely, that he/she has not injected enough insulin). A non-diabetic will always produce the requisite insulin and so his/her blood ketone level will never go above something like 4 or 5 (if I remember right - I can't quite remember the exact numbers or units, but it is something like that, if someone else knows the exact figures please correct me) - whereas the blood ketone level in a diabetic in a ketoacidic state will reach 30, 40, something like that. What happens is that when the ketone levels are so astronomically high in the diabetic, his/her body actually becomes acidic, leading to diabetic coma and potential death. This is IMPOSSIBLE in a non-diabetic.
The jury still seems to be out on whether ketones are dangerous to the fetus... some doctors seem to worry about it a lot, and others don't seem to care at all. My personal take is that anyone who has had bad morning sickness and can't eat much at all will automatically go into nutritional ketosis. I don't think it is any kind of emergency. Also, I have read that the studies that made everyone get so worried about ketones in pregnant women were actually done on UNCONTROLLED diabetics - not healthy women in nutritional ketosis - so there is a high possibility that the actual danger to the fetus was in fact high blood sugars rather than the ketones, or perhaps a combination of the high sugars and the ketones, but the studies didn't show that ketones would be dangerous in the absence of high sugars. At least that is my laywoman's understanding of the studies!
Hope that helps!!
Thanks for all the info everyone! I have fruit at breakfast and have been having rice at lunch, but still spill ketones in the evening some days, so I've been working on upping my carbs even more.
Some people think ketosis is healthy, and some are very against it.. So I guess I will be on the safe side and try to stay out of it. I feel like I am eating well, so if I spill them sometimes I'm not going to get crazy with worry.
sounds like a great plan, josie! best of luck and keep us posted!
Just a quick question I forgot to ask, could the ketosis be causing my headaches? When I don't have a headache I feel wonderful, but I get one almost every day now, starting mid-day. I do remember having a lot at this point in my last pregnancy though, and I wasn't in ketosis with him. I just don't know..?