What type of doctor would know about low potassium & low phosphorous issues?

[Mary]

Do you have some high carb elements in your diet such as fruit, rice, potato, pasta, starch, bread, juices?

Almost none. I'm very careful about sugar and white foods. In reading about phosphate diabetes, I haven't seen any connection with regular diabetes (related to sugar). Rather, it has to do with decreased tubular reabsorption of phosphate. https://www.ncbi.nlm.nih.gov/pubmed/19078033
https://www.ncbi.nlm.nih.gov/pubmed/16214071
I only had one low ALP reading several years ago. And again, I'm theorizing that my hypophosphatemia issues are related to refeeding syndrome. Hypophosphatemia is the hallmark of refeeding syndrome. My hypophosphatemia symptoms hit a day or two after I started taking thiamine, much the same way that hypokalemia hit me a day or two after starting methylfolate.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440847/

I'm keeping my hypophosphatemia symptoms at bay with a combination of kefir and a monosodium phosphate supplement.

Yeah, I had a bad reaction to keto. I started crashing much easier and my crashes lasted longer. I think it depleted BCAAs for me, and BCAAs have cut my PEM recovery time by more than half. I have toyed with the idea of trying again slowly, but am working on some other things right now, so it's on the back burner for me.

 

[BeADocToGoTo1]

Hi Mary,

Thanks for the links !

The monosodium phosphate supplement is intriguing. Would you mind sharing the brand that was helpful as I think I would like to experiment with that a bit.

Interesting to read that it is often tied to malnutrition and electrolyte imbalances. Any form of malabsorption immediately comes to mind as well as not enough high quality, trace mineral rich, salt. The ketogenic aspect and intracellular mineral deficiency mentioned ties directly to what Dr. Phinney was saying in one of his videos about increasing salt intake when in nutritional ketosis. I will have to check whether himalayan salt is high in phosphorous. Insulin also causes issues, especially when already low in phosphor, which is another reason why lower carb is so important.

Not sure whether there has been a better intracellular test made easily available than the Spectracell, which some have had some inconsistent results with.

 

[BeADocToGoTo1]

Hi @Mary

I was thinking of you today. How did your visit with the new doctor go? Any new light shed on the problem?

 

[Hd-x]

P intake is regulated by Parathormone thus Vitamin D levels play in there.
Endocrinoligst may be perhaps a doctor for low P issues, but usually they dont help much if it is rare that low P levels persist if you have fine vitamin D levels. In such a case any malabsorbation or so, could be a reason,

MSP (monosodiumphosphate) is availible from Swanson.
MSP has some limited use in some sports to enhance endurance.
CGP or COP can be used alternativly to increase P-intake if MSP is not availible in any local stores.

 

[Mary]

The monosodium phosphate supplement is intriguing. Would you mind sharing the brand that was helpful as I think I would like to experiment with that a bit.

Hi @BeADocToGoTo1 - I just saw this post (the tag didn't work, no "@" sign in front of my name) - anyways, I've taken 2 products: one by Swanson and one from Amazon. They seem to work equally well, I think they're the same thing. The Swanson product comes with a very small scoop which measures 250 mg., and that's what I take 2 to 3 times a week. I just dissolve it in water, it tastes a little salty. Apparently the Amazon product is not available right now, in the 4 oz. size. There is a 2 lb. size (!) which is way too much. But you can still get the Swanson's product.

I will have to check whether himalayan salt is high in phosphorous.

I just took a look at one analysis and Himalayan salt appears to be very low in phosphorus: https://themeadow.com/pages/minerals-in-himalayan-pink-salt-spectral-analysis

Hi @Mary

I was thinking of you today. How did your visit with the new doctor go? Any new light shed on the problem?

Unfortunately no, at least not yet. He checked my thyroid and adrenals, and hand wrote an order for phosphorous but the lab over looked it! And the doctor didn't notice till I brought it to his attention. He listened to me, but it's so hard trying to explain what's going on - refeeding syndrome and thiamine and all that. Anyways, I'll get my phosphorus checked in a couple of weeks. However, since I take a supplement, it could very well test in the normal range. And there is the possibility of low intracellular phosphorus despite normal blood work - I don't know if this is a possibility but it does happen with potassium.

So basically no new information, yet.