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    Valkyria's Avatar
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    Pregnancy and ketones

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    I'm expecting twins 30 June so I've been going for scans/check ups quite often. The last one was yesterday. Everything was fine with the twins, a bit on the small side, but that's normal. My blood pressure was ok(100/60), but they did find protein and ketones in my urine. They found proteins last time as well, but that turned out to be nothing to worry about so I'm hoping it's the same this time.
    But with regards to the ketones I was told I need to eat more to avoid going into starvation mode, and that if it had been 1 number higher I would have been admitted to hospital.

    I haven't managed to find out much about pregnancy and ketones, only CW stuff so I was hoping any of you guys have any information. Is it something to worry about, or is it just a side effect of being primal?
    "All things are poison, and nothing is without poison; only the dose permits something not to be poisonous."
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    I'd personally add some more carbs in.. .. in the form of sweet potatoes, starchy veggies and fruit. I've heard some say it was OK and others say it causes epigenetic changes if you are VLC.
    Primal since March 2011

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    You need to get 150 carbs minimum per day with a twin pregnancy - more likely 200 or more since the load on your body is heavier than with a singleton. There is no reason to be VLC while pregnant if you are eating primal - just eat primal carbs in good amounts. Otherwise your babies will get the message that they are coming into a world with limited food which will set them up for obesity (which makes sense - if you're born in a place with limited food you want your body to be good at storing fat and maintaining weight on little food, but that's not the situation your babies will be born into).
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    Valkyria's Avatar
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    Thanks for the advice guys.
    The thing is I'm not VLC, I haven't worried about eating too much carb at all. I eat fruit/berries every day, sweet potato and potatoes a few times a week, white rice or homemade rice bread/pancakes most days. I even have sugary drinks from time to time.
    I guess I just have days were I just don't eat enough ... My appetite has changed a bit, and sometimes I just don't fancy anything ...
    Shouldn't be long before they're here anyway so I'll just have to do the best I can the last few weeks I guess.
    "All things are poison, and nothing is without poison; only the dose permits something not to be poisonous."
    Paracelsus

    A Primal Twin Pregnancy

    Proud mother of twin girls!

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    Lewis's Avatar
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    Quote Originally Posted by Valkyria View Post
    But with regards to the ketones I was told I need to eat more to avoid going into starvation mode, and that if it had been 1 number higher I would have been admitted to hospital.
    Did they ask you how much you were eating?

    I say that because it seems to me that they were jumping to conclusions, if they didn't. Maybe the ketones shouldn't have been there, and there are probably a number of good reasons for looking for them -- not least I'd guess because they could be there as a result of the patient's alcohol consumption. But how do they know it's because you're starving yourself. It would worry me a little that they should assume what I take it isn't true rather than looking into why they're getting a higher reading than they expected.

    I haven't managed to find out much about pregnancy and ketones, only CW stuff so I was hoping any of you guys have any information. Is it something to worry about, or is it just a side effect of being primal?
    Sorry, I don't know anything about ketones and pregnancy and would not like to guess on medical matters.

    As for would ketones in the urine a side-effect of being primal? -- well, I guess that would depend on one's understanding of what it meant to eat a primal diet.

    If that meant someone was eating around 60 g of carbohydrate a day (plus moderate protein), then their serum level of beta-hydroxybutyrate would go up above 0.5 mM after a few weeks. That's about ten times as high as someone taking in around 300 g a day of carbohydrate. However on less than 20 g of carbohydrate a day (plus, again, moderate protein) serum B-OHB levels can be up to around 3 mM. On total starvation (no carbs and no protein) serum B-OHB levels can rage away up to 5 mM.

    These figures come from Volek and Phinney: The Art and Science of Low Carbohydrate Living

    Do we know which ketone the hospital is measuring, though? For example, I understand the ketostix measure not B-OHB but acetoacetate.

    AFAIK, there's some individual variation as to how people handle ketones, so some people eating a VLC version of primal might see them go up much more than others. And the concentration of them in your urine is going to be dependent on how hydrated you are anyway. Obviously, if you're drinking plenty of water, there's more volume of urine for them to be in.

    None of this seems at any rate on the face of it to apply to you. You're not starving yourself, neither are you eating a very low level of carbohydrate.

    According to NIH of the United State:

    Ketones are always present in the blood and their levels increase during fasting and prolonged exercise. They are also found in the blood of neonates and pregnant women. Diabetes is the most common pathological cause of elevated blood ketones.
    Ketone bodies: a review of ph... [Diabetes Metab Res Rev. 1999 Nov-Dec] - PubMed - NCBI

    So evidently a certain level is normal for pregnant women. It seems to me it would be difficult to know what's going on when we don't know which ketones they're measuring and what the actual figure in mM is. And then again, how much water (and other fluids) had you drunk that day?

    I've no medical qualifications and so can't offer medical advice. Here's what I suggest. The hospital must have sent the results back to your doctor -- your own GP. I think perhaps you might go to see your GP and ask him or her to explain further, to tell you just how elevated this is -- what's the figure? -- and to tell you what the possible reasons for that are. If your doctor thinks it of importance, I guess he or she will have it measured again.

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    onalark's Avatar
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    Quote Originally Posted by FrankiG View Post
    You need to get 150 carbs minimum per day with a twin pregnancy - more likely 200 or more since the load on your body is heavier than with a singleton.
    Hi, where do you get this number from? Just curious.

    Thanks!

  7. #7
    Dr. Bork Bork's Avatar
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    Quote Originally Posted by onalark View Post
    Hi, where do you get this number from? Just curious.

    Thanks!
    maybe cuz pregnant mama needs 50, and each kid needs 50? Guessing here.

    I wouldn't worry about it, personally, but I'm naughty like that. If you feel great, and babies are doing great, then great. Keep on keeping on. I freak out my doctor if I go in for blood work after gym while fasting and whiz out proteins.
    Ketosis is not bad. Ketoacidosis is.

    I'm probably quackers, but there's my opinion on the matter. Keep following your body's cues and be totally amused watching the L&D staff run around like headless chickens.
    --Trish (Bork)
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    Quote Originally Posted by Valkyria View Post
    I'm expecting twins 30 June so I've been going for scans/check ups quite often. The last one was yesterday. Everything was fine with the twins, a bit on the small side, but that's normal. My blood pressure was ok(100/60), but they did find protein and ketones in my urine. They found proteins last time as well, but that turned out to be nothing to worry about so I'm hoping it's the same this time.
    But with regards to the ketones I was told I need to eat more to avoid going into starvation mode, and that if it had been 1 number higher I would have been admitted to hospital.

    I haven't managed to find out much about pregnancy and ketones, only CW stuff so I was hoping any of you guys have any information. Is it something to worry about, or is it just a side effect of being primal?
    Wow, that's horrible info. Ketone bodies are produced as a beneficial byproduct of fatty acid metabolism. Beneficial because various tissues in your body, like the heart and brain, can use ketone bodies as fuel. If it's ending up in your urine (and breath) it just means your body isn't using all the ketones produced, hence ketosis.

    Ketones is not a sign of "starvation mode." It's a sign of fatty acid metabolism. Until the gluconeogensis is renal based, you're not really close to being in starvation mode.

    http://www.med.upenn.edu/timm/docume...8-9Lazar-1.pdf

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    onalark's Avatar
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    Quote Originally Posted by Dr. Bork Bork View Post
    maybe cuz pregnant mama needs 50, and each kid needs 50? Guessing here.
    Meh. If so, I don't buy it. 50 grams is for a full grown adult.

    I agree with your assessment to focus on feeling great and listening to the body's cues. So long as you're tuned into that, I think it'll be fine. I would feel a little sorry for any ladies just starting primal and instantly getting pregnant, though. I think it's a benefit to have done this for a year before setting up shop as a human incubator.

  10. #10
    Valkyria's Avatar
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    Thanks for your input everyone. I really appreciate it.
    I was just thinking of going with what feels right, and I feel like I'm more in tune with my body now and can listen to what it needs.
    Everything has been going fine so far, and although I'm 37 weeks and 3 days now I still feel great.
    "All things are poison, and nothing is without poison; only the dose permits something not to be poisonous."
    Paracelsus

    A Primal Twin Pregnancy

    Proud mother of twin girls!

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