# Dietician appointment & diet side effects



## Lucyr (Jul 22, 2022)

I hate to start with a caution but it's probably important to clarify upfront: I am very hesitant to talk about diet here, it's something I deliberately avoid discussing because it's a tricky area and many people's views are more extreme than is helpful for me. So, please be kind in your replies. 

My normal diet is pretty carb-based, I have IBS-type issues and plain carbs are the only thing that settles it down. I've also had quite strong mood reactions to low carb previously that have made it unmanageable. I adjust insulin to account for the carbs which has previously worked very well, but it's fair to say it's been very hit and miss this year. Ever since I had flu at Christmas, I've struggled with blood sugars being higher, energy levels much lower even when bgs are good, gained weight, just not been right all year basically. Previously I've lost weight best through calorie counting but struggled with that this time too, I just don't have the energy to keep up the counting. 

So, i spoke to a diabetes dietician this week for some help. We made a plan, which is basically to eat normally but halve the portion of carbs and add an extra portion of fruit or veg, and add some snacks to avoid getting too hungry. I'll put the examples we talked through below. I've started the last couple of days but I'm already feeling worse, and not sure if this is related to the reduction in carbs, or still lingering post-viral fatigue flaring up again, or something else. The main things bothering me are intermittent lightheadedness, headaches, extreme tiredness, upset stomach, and mood changes. 

*Suggested Diet*
Breakfast: 1 piece toast with light spread, and either a veg (eg mushrooms) or a fruit (berries, satsuma or melon)

Lunch: Sandwich with 1 piece bread, and protein&veg as filling. Also a small salad with added lean protein and light dressing. 

Snack (2/3 a day): rice cake with soft cheese, or veg sticks with soft cheese, or bit of fruit (berries/satsuma/melon), or dark choc. If having anything else limit it to under about 100-calorie snacks. 

Dinner: Normal meals but halve the recommended carb portion and add a veg. Eg tonight i had a chilli (lean mince, courgette, mushrooms, kidney beans and chickpeas) with half the pack suggestion of brown rice, sweetcorn, peas. 

*Actual Question*
I reckon thats about 100-110 carbs today. Any ideas on what kind of side effects can happen when starting a diet and how often they settle down?


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## Lucyr (Jul 22, 2022)

oh she did also say start exercise: 30 min walk with some brisk intervals, 5x a week, and swiming 1-2x a week. But honestly i'm just so exhausted i can't even imagine trying it. 

Back in a month to update on how it's going in terms of weight, how it's going, whats difficult, etc


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## Leadinglights (Jul 22, 2022)

How much of a reduction is it in the amount of carbs compared to what you were having before as there is something that is referred to as keto flu which has symptoms much like you describe. It can occur when people suddenly cut carbs.


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## Lucyr (Jul 22, 2022)

Lets estimate something like 180 previously down to 100 today so 40%+ reduction. I'm way above keto levels and spread the carbs through the day, did check i dont have ketones when feeling ill yesterday.


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## Leadinglights (Jul 22, 2022)

Lucyr said:


> Lets estimate something like 180 previously down to 100 today so 40%+ reduction. I'm way above keto levels and spread the carbs through the day, did check i dont have ketones when feeling ill yesterday.


I know you are well above keto level but it could still be caused by a sudden reduction in carbs which can also cause dehydration as cutting carbs can result in fluid loss and upset electrolyte balance.


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## nonethewiser (Jul 23, 2022)

Lucyr said:


> I hate to start with a caution but it's probably important to clarify upfront: I am very hesitant to talk about diet here, it's something I deliberately avoid discussing because it's a tricky area and many people's views are more extreme than is helpful for me. So, please be kind in your replies.
> 
> My normal diet is pretty carb-based, I have IBS-type issues and plain carbs are the only thing that settles it down. I've also had quite strong mood reactions to low carb previously that have made it unmanageable. I adjust insulin to account for the carbs which has previously worked very well, but it's fair to say it's been very hit and miss this year. Ever since I had flu at Christmas, I've struggled with blood sugars being higher, energy levels much lower even when bgs are good, gained weight, just not been right all year basically. Previously I've lost weight best through calorie counting but struggled with that this time too, I just don't have the energy to keep up the counting.
> 
> ...



Apart from gaining weight had exactly same symptoms as you putting it down to ibs as did Dr, eventually after stool sample got proper diagnosis of Exocrine Pancreatic Insuffiency, often shortened to just EPI, after starting on Creon felt so much better & ibs type symptoms settled down & energy levels returned.

Not suggesting for one moment it's EPI in your case but something your Dr should rule out, Fecal Elastase Test will do just that.


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## Lucyr (Jul 23, 2022)

nonethewiser said:


> Apart from gaining weight had exactly same symptoms as you putting it down to ibs as did Dr, eventually after stool sample got proper diagnosis of Exocrine Pancreatic Insuffiency, often shortened to just EPI, after starting on Creon felt so much better & ibs type symptoms settled down & energy levels returned.
> 
> Not suggesting for one moment it's EPI in your case but something your Dr should rule out, Fecal Elastase Test will do just that.


Thanks I’ll look it up, I’ve had these problems for such a long time and had colonoscopies etc but no issues found so stopped looking into it.


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## nonethewiser (Jul 23, 2022)

Lucyr said:


> Thanks I’ll look it up, I’ve had these problems for such a long time and had colonoscopies etc but no issues found so stopped looking into it.



Had same procedures years before, it was sometime after that young Dr at gp surgery requested Fecal test. Anyway good luck hope new diet helps matters.


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## EmmaL76 (Jul 23, 2022)

Me too, I’m currently doing a microbiome test to try and get to the bottom of my tummy troubles. I’m so sick of it, at the moment it’s particularly bad, my stomach area under my ribs is so painful and swells so much I feel like I can’t breathe. Had scans and stuff but thanks @nonethewiser never realised EPI had similar symptoms to ibs. Sorry your struggling so much @Lucyr, it’s really horrible to feel this way, I too am exhausted all the time, I’m assuming for you  they have rules out the usual suspects like, thyroid, anemia and b12 d vits etc ?


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## Lucyr (Jul 23, 2022)

I’m not sure EPI fits for me as I haven’t lost weight, presumably as I can digest carbs so long as I bolus for them, it’s only fat I have a problem with and I try to avoid that (other than whole milk which I should try switching, it’s just so nice in coffee) and having been too tired to do any exercise won’t have helped the weight either. Still, I’m down 1 pound so far now. 

Sorry you’re having problems too @EmmaL76 I haven’t been to the doctors about it recently, I did go earlier in the year and had blood taken by drs and the hospital a few times. Can’t remember what they tested for as it was mainly about the headaches, but I’m sure a full blood count and thyroid would have been on there. Not as sure about b12 (but that would affect full blood count if off anyway?) and vitamin d as probably not standard tests. It was all diagnosed as post viral fatigue, but then I got covid whilst already having post viral fatigue so I do wonder if it could have just set off long covid which is essentially the same thing. 

I might give it a couple of weeks of the new diet, maybe try a multivitamin too, and go to GP again if it’s still a problem.


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