Advice re. water retention please.

Hi all!

I am having some problems with a very swollen foot/ankle. It is my left foot and my right is completely normal. I have had this problem occasionally flare up at winter and I associated it with bad circulation as I also had chillblains. However being more active in an effort to improve my health, weight and circulation seems to have stopped the chillblains, but the swollen foot has gotten worse since this spring.

It coincides with me being stricter with my diet, very low carbs, higher protein and fat, cutting out gluten and cutting down on milk. I also started to take modified release metformin at the end of last year which was prescribed to help sort my menstrual cycle (I bled for about 48 weeks last year) and this seems to be fixed now, my cycle is regular but very heavy.

I had some blood tests which ruled out kidney or liver problems - I have a different set of tests to have done tomorrow. The doctor suspects gout although after reading up on that myself I don't think it is as I don't have any joint pain - any pain has been from tight and tender skin. As a previous blood test highlighted a vitamin d deficiency he says I may need injections to help with this - is this something I should potentially be concerned about?

I also have to take thyroxine for an underactive thyroid, and have difficulty losing weight despite eating very little. For example today I had one sausage for lunch, and about 200g of organic beef made into burgers with a little onion, grated cheese, salt and pepper with 2 very small avocados I squashed into guacamole with some of the fat collected from the burgers cooking.

My doctor said that too much protein could be the problem, causing fluid not to be flushed properly, also the fat cells absorbing oestrogen causing the hormonal problems messing with my cycle (despite hormone screens and tests showing as "normal").

I am confused much, and concerned that this problem seems to be getting worse despite me actively trying to improve my diet and physical activity.

You should probably cut out the dairy altogether, and may want to cut down on the avocados and up your fats somewhat. Also, have you tried making bone broth?

truth seeker said:

You should probably cut out the dairy altogether

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Yes, dairy should be avoided completely

truth seeker said:

and may want to cut down on the avocados

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Why cutting down avocados? They are excellent source of healthy fats and potassium.

You have water retention probably because of high insulin level caused by too much protein:

From Maria Emmerich's Keto-Adapted:

Excess insulin also activates the kidneys to retain fluid. I had one client who was extremely obese and would fluctuate up to twenty pounds daily because of water retention. Yep, twenty pounds of water retention! She was experiencing pitting edema in her lower legs. To test if you also have pitting edema, press your finger into the tissue of your shin bone. If your finger leaves an indentation (basically your finger print), you have pitting edema. Most obese clients complain of this sensation late in the afternoon or after being on their feet all day. What’s happening is the excess water retention gathers in the lower legs and soaks into the soft tissues. During sleep, when the body is horizontal through the night, the fluid is redistributed into the upper body. Come morning, the pitting edema has gone away, but then returns as the day goes on. This happens to anyone with insulin issues — it is just more noticeable in those who are overweight. When clients first adapt to the keto-adapted lifestyle, one of the first side effects is a rapid improvement in insulin sensitivity. Eating low-carb causes insulin levels fall quickly, and your body starts to banish insulin resistance. As insulin levels fall, the kidneys begin to promptly release fluid. One common complaint I get from clients when they first adopt this lifestyle is that they are up in the middle of the night urinating more than usual. This will go away eventually, which is a good thing, but there is also some bad news that comes along with it.

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Thank you for the information so far! I often have trouble with finding appropriate information as some seems conflicting. I am obviously treating the diet incorrectly and balancing too much protein over the fat.

I haven't made any broth recently - I have made it in the past with chicken carcasses . I get a little overly concerned at times that I am doing things incorrectly, I work with a small grocery budget but I do try to be careful about what I buy.

Hi Soluna,

Sorry to hear about your health problems. My 2 cents:

Soluna said:

It coincides with me being stricter with my diet, very low carbs, higher protein and fat, cutting out gluten and cutting down on milk.

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Higher protein should be moderate protein. If you eat too much protein, it converts into glucose and you'll be having the same problem. In my case, my head area is the most sensitive, when I eat too much protein, the blood flow somehow gets disrupted and I get a headache, the same happens if I have too many carbs.

Also see: Protein: How Much Is Too Much? _http://www.primalbody-primalmind.com/protein-how-much-is-too-much/

I think the most important thing for you to do would be to read a book on the ketogenic diet (like the one mentioned by Altair), so that you know why you do what you do, and what you should be careful about (if you haven't already).

Soluna said:

I also started to take modified release metformin at the end of last year which was prescribed to help sort my menstrual cycle (I bled for about 48 weeks last year) and this seems to be fixed now, my cycle is regular but very heavy.

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In my case, overall, the ketogenic diet has reduced discomforts during my cycle enormously, so I think that once you keep at it, with time it might become less heavy.

Soluna said:

I had some blood tests which ruled out kidney or liver problems - I have a different set of tests to have done tomorrow. The doctor suspects gout although after reading up on that myself I don't think it is as I don't have any joint pain - any pain has been from tight and tender skin. As a previous blood test highlighted a vitamin d deficiency he says I may need injections to help with this - is this something I should potentially be concerned about?

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Are you also taking magnesium? Vitamin D interacts with other vitamins and minerals as well, if your doctor takes this into account, then maybe it will be helpful. Or you could spend some time in the sun every day (if there are sunny days where you are!), or perhaps consider a product called "BLUE ICE™ Fermented Cod Liver Oil" which some people say is a good source for this vitamin. Lard also has vitamin D, they say that next to cod liver oil, it's the "second richest dietary source of vitamin D".

Hope this helps.

Soluna said:

I also have to take thyroxine for an underactive thyroid, and have difficulty losing weight despite eating very little. For example today I had one sausage for lunch, and about 200g of organic beef made into burgers with a little onion, grated cheese, salt and pepper with 2 very small avocados I squashed into guacamole with some of the fat collected from the burgers cooking.

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Is this all you had during the whole day? It does sound like a lot of protein.

It seems that at the moment you are kind of in-between Paleo and Keto, but in one case without the carbs and in the other without the fat.

If you want to "stay" Paleo, you should def. eat some veggies with your meat and not worry about the carb intake from them (but no gluten or sugar!), or, you venture into Keto, go really low on carbs, but up the fat dramatically.

As the other posters I would suggest to read Maria Emmerichs Keto Adapted, there are quite a few testimonials of people who lost a lot of weight with the Keto diet and see if it would be something for you. I assume it would help you with your period, too.

M.T.

I have a similar problem and with the left ankle too. It always blows up if my protein levels are too high in relation to fats OR if I eat anything that I'm sensitive to including egg whites, dairy, nightshades, and more than 10 or so grams of carbs per day. As Jimmy Moore says in his book "Keto-Clarity", you have to find your carb tolerance level and it is different for everyone. Those who have very low tolerance just have to fill up with fats. I'm using his method of eating a bite of butter with each bite of meat and usually the butter bite is bigger than the meat bite. That way, you get very full long before you finish. And, doing this has finally stopped that annoying leg swelling.

Also, the cold adaptation thing really helps the circulation and skin. I had an annoying problem of having these weird, bloody bruises all over my arms because every time I bumped them or even just scratched an itch, a big patch of leaking blood would appear just under the skin. Well, the cold dips have fixed that, too! Bonus is the fading of the "age spots"!

When my feet get swollen it's an indicator to me that I ate something my body doesn't agree to. In my case it's alcohol, sugar, too much protein, carbs, even certain fruits that are very sweet. I haven't had gluten or dairy in ages, but I think they would swollen my feet too. So I pay attention to how my feet feel because they give me good indicators as to what to avoid. Also, my lips and tongue get swollen when I eat specific spices, like cinnamon or peppers, and nightshades.

Next to the advice given to you so far, I would also add the quality of the salt you use. On keto diet I need a lot of salt and I found that eating commercial salt leads to water retention. But pink salts or unrefined ones, do not. There was a good article on sott a while back, with good info:

http://www.sott.net/article/278387-Why-real-salt-is-so-important

another

http://www.sott.net/article/258124-Real-salt-Celtic-salt-and-Himalayan-salt

Altair said:

Why cutting down avocados? They are excellent source of healthy fats and potassium.

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True, but since they can inflame me at times, I figured that cutting it down to maybe one might help a bit. The suggestion on salts was also something I was thinking of.

My current understanding of the diet is that it's a constant progression. What that means is that as one gets 'cleaner', they may begin to react to things that previously caused no reaction. So there is a continuous readjustment. It's more like a journey than a destination.

truth seeker said:

Altair said:

Why cutting down avocados? They are excellent source of healthy fats and potassium.

Click to expand...

True, but since they can inflame me at times, I figured that cutting it down to maybe one might help a bit. The suggestion on salts was also something I was thinking of.

My current understanding of the diet is that it's a constant progression. What that means is that as one gets 'cleaner', they may begin to react to things that previously caused no reaction. So there is a continuous readjustment. It's more like a journey than a destination.

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Can it be because of pecticides or other chemicals in avocados you eat? As far as I know there is nothing in pure avocados which could cause inflammation

I wonder too if it isn't some inflammation coming out from the remaining dairy in your diet. I would definitely try cutting out all dairy. You may be giving up a 'treat' or something you like, but you usually get much back in return. If you are eating too much protein your body will convert it to glucose and that is very straining to your system and keeps your body from going into healing mode.

Altair said:

truth seeker said:

Altair said:

Why cutting down avocados? They are excellent source of healthy fats and potassium.

Click to expand...

True, but since they can inflame me at times, I figured that cutting it down to maybe one might help a bit. The suggestion on salts was also something I was thinking of.

My current understanding of the diet is that it's a constant progression. What that means is that as one gets 'cleaner', they may begin to react to things that previously caused no reaction. So there is a continuous readjustment. It's more like a journey than a destination.

Click to expand...

Can it be because of pecticides or other chemicals in avocados you eat? As far as I know there is nothing in pure avocados which could cause inflammation

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Even if it's organic, I can have a reaction which is a shame as I really like them. It's not overt, but if I'm only on meat, fat and broth for a while and then have a carb, I tend to feel it. I will, however have them every now and again because I 'like' them so much.

truth seeker said:

Even if it's organic, I can have a reaction which is a shame as I really like them. It's not overt, but if I'm only on meat, fat and broth for a while and then have a carb, I tend to feel it. I will, however have them every now and again because I 'like' them so much.

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You're not alone in this, truth seeker. ;) I can't eat any carbs without inflammation affecting me. And, I, too, really like avocados - and garlic and onions and tumeric (which is very good for people, but not for me) and a whole lot of other things that some people can enjoy and not have a reaction to and that are supposed to be good for one's health.

It's all about just how damaged our guts are, or so I think. So just because some people can eat these things doesn't mean that all of us can. Without not eating them for a couple of weeks, and, then, reintroducing them, people are not going to be able to know what things actually cause them inflammation and what things won't. Just assuming that the things that are 'healthy' or that cure this or that means that they don't cause inflammation is wishful thinking for some.

Thank you all for all of your insights.

It certainly seems tricky, trying to identify things that can cause such individual effects in all of us.

My doctor just phoned me with the results of the different blood tests I had done yesterday (really quick response!). He says it's definitely a form of gout as my uric acid levels are much higher than they should be - normal is apparently 120 ish and mine is 440. He also says my vitamin D is very low, my thyroid levels are ok at the moment and my calcium is fine.

His treatment plan is:
Drinking more water - 2-3 more pints a day.
Vitamin D supplements which I have to go and pick up the prescription for (I will have to check out what is in these).
Dietary changes - he says more dark green leafy vegetables.

Obviously where I had changed my diet to cut out grain carbs and reduce other sources of carbs I have over compensated on the protein; meat, eggs and fish.
I did my grocery shopping yesterday. I wanted to get a leg of lamb for the bone but it's so expensive! So I settled for 2 whole chickens, and I will use the carcasses to make broth. I also bought some other types of fats, clarified butter, beef dripping for example. I had been using lactose free milk for my occasional coffee but I bought some coconut milk to cut out that dairy completely.

Now I need to read up and see how I can adapt my meals with the fats - learning 'how' to eat what you 'should' be eating seems far trickier.

Thank you again all for adding some much needed clarity, insight and balance to these confusing issues.

I've had a similar issue but mine was mostly in the right foot and ankle. Even with loads of water (the body tends to retain water if you're not drinking enough) it was still present. Low carb, no carb didn't eradicate it completely. After going back to cold baths, the problem was gone in a few days.

Welcome back skinny feet. :)