Hypoglycemia, ketones in urine and weight lost. I need advice.

[yellowstone]

Due to malabsorption, I have hypoglycemia and I excrete ketones in my urine. I am losing a lot of weight. I don’t know what to do — I drink juice, eat fruit, take honey, but I don’t notice much improvement. Any advice?

[knitty kitty]

@yellowstone,

You poor thing! 

I'm not a medical doctor, but it sounds like "Refeeding Syndrome".   I suggest you seek medical attention.  

Refeeding Syndrome occurs when your body doesn't have enough of the necessary vitamins, especially Thiamine, to turn sugars (from the fruit, juice, and honey) to turn provide energy.  

This can occur in Malabsorption due to Celiac Disease.  Malabsorption prevents the absorption of B vitamins, especially Thiamine. The B vitamins and Thiamine cannot be stored long in the body. 

When you run out of Thiamine, your body burns fat for energy which produces the Ketones, hence your weight loss.

With medical attention, Thiamine and other B vitamins need to be replaced before giving any more sugars.  Doctors can give you an IV containing B vitamins including Thiamine, called a "banana bag".  Riboflavin  Vitamin B2 causes the yellow color.  

Doctors can also monitor your electrolytes which can become unbalanced and cause further serious health issues.

I've experienced Refeeding Syndrome.  It's very scary.  Health can deteriorate quickly in Refeeding Syndrome.  It's correctable, but complicated.  

I strongly urge you to get professional medical attention as soon as possible.  

Our prayers are with you!

https://my.clevelandclinic.org/health/diseases/23228-refeeding-syndrome

Thiamine Deficiency in Self-Induced Refeeding Syndrome, an Undetected and Potentially Lethal Condition

https://pmc.ncbi.nlm.nih.gov/articles/PMC4295429/

Keep us posted on your progress!

[Aretaeus Cappadocia]

Your post doesn't mention if you are seeing Doctors about this and what they had to say, or if you are just trying to manage it by yourself.

If you aren't getting medical support, that is the first place to go.

On the other hand, if you've been on a diagnostic odyssey with Dr after Dr being perplexed, consider getting your genome sequenced (search for "whole genome sequencing"). It's not guaranteed to get you an answer, but if your symptoms are caused by a genetic condition you might get the answer that is stumping standard differential diagnosis. These days there are quite a few companies offering this service. I wish I could tell you which one was best but I've been out of that field for a decade. Talk to your Dr about this and see what they think. Price is probably ~$500-$1,500 including the sequencing and detailed reports. Sounds like a lot, I know, but consider that 25 years ago just the sequencing (no reports) cost $2.7 B and took 3 years to complete.

[Scott Adams]

That sounds serious, and with hypoglycemia, ketones in the urine, and ongoing weight loss, this is really something that needs prompt medical attention rather than home advice alone. Juice, fruit, and honey may give a short-term sugar boost, but they do not address the underlying cause of continued weight loss and ketones, especially if malabsorption is involved. Please contact your doctor as soon as possible, and if you are feeling weak, dizzy, confused, vomiting, unable to keep food down, or getting worse, seek urgent care right away.