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I'm helping my 30-year old sister, who for a long time has had many health problems including systemic fibromyalgia-type pain symptoms and insomnia, start to eat paleo, as of last week. Her prior diet was tons of sugar, chips, some cheap meat, and lots of french fries.

A week ago she switched cold-turkey to virtually 100% paleo from her crappy diet. Only concessions are for stevia sodas (which she already drank before), a little honey, and some nitrate-free processed meats. She can't tolerate fish oil so we're figuring out ways to get flax, chia, and algae-based DHA into her.

She has reported that as of the day she started on paleo last week, she developed frequent urination, which is a problem since it interrupts her already-tenuous sleep. She suspects it is from "high protein" since this happened to her before when she used to make a lot of whey smoothies. The peeing is out of proportion with any possible changes in her fluid intake. She's "skinny fat" body type; it seems hard to believe all this peeing is from temporary loss of water retention, though I'm not ruling it out.

I've read some critiques of high-protein diets that argue excessive urination can be a symptom due to the extra nitrogen, ketones etc. I see her new diet as being higher, but not excessively high in protein; so far she's eating pretty normal servings of protein according to her appetite, and some good quality fat from coconut, butter, and omega-3 supplements instead of all the carbs. Is it possible her weak metabolism doesn't know what to do with the protein quite yet, and isn't processing it right? (At the moment she is pretty intolerant of exercise so only gets a little bit from walking around.)

Since her system is very weak overall we intend to bring this up with her MD in case there's an organ pathology, but I was wondering if anyone has thoughts on why this could be happening, if it might be a transitional thing, suggestions, etc. beyond what was covered in this guy's post. Thanks!

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You don't say whether or not she's doing low-carb paleo or not, but I'd suspect that this is water loss from burning through stored glycogen. If she's doing low-carb, this shouldn't go on indefinitely. If she's cycling carbs, it could come and go.

Note: it's not required that one eat excessive amounts protein on a paleo diet. If she's doing low-carb, then she could try increasing calories from good fat sources. if she's not doing low carb, then dialing down the protein and balancing her meals with safe starches, fruits & veggies and fats would be worth a try.

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She's eating low-carb, lots of good fat and moderate protein. It's a little more protein than she was used to before. Way less carb than she was eating before but there are medical reasons we are trying low-carb. When you say burning through stored glycogen... I'm familiar with the basics of glycogen/glucose metabolism but don't quite understand. Thought we all keep glycogen stored until needed, and then replenish it after it is used? Does one's overall glycogen "load" vary based on the diet? – Rockgrrl Aug 29 2011 at 1:25
Here's a good general <a href="phlaunt.com/lowcarb/…;, but basically, when you go low-carb, your body starts using your stored glycogen to provide glucose until you've adapted to low-carb. If you're eating low-carb, you don't replenish the glycogen until you start eating lots of carbs again (or perhaps if you're really eating excessive amounts of protein ... glucose can be generated from amino acids). – Beth-WeightMaven Aug 29 2011 at 16:45
I've seen different numbers re how much glycogen is stored, but in general, there's 3-4g of water for each g of glucose. So when your body uses the glycogen and doesn't replace it, it winds up meaning lots of trips to the loo! – Beth-WeightMaven Aug 29 2011 at 16:45
Here's another good link: justinowings.com/… – Beth-WeightMaven Aug 29 2011 at 16:47
the glycogen water is only for a few days if one is doing low carb for real. – The Loon Aug 30 2011 at 15:03
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First, has she dramatically increased the amount of protein, or just gotten rid of the junk? It could be that in addition to "water" weight loss that she is also experiencing a reduction of insulin and this can cause fluid loss as well.

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Not a dramatic increase, more gotten rid of the junk-- she was accustomed to frequently dosing herself with carbs and sugar. I do think you're right that she's having a reduction of insulin, wasn't aware that this could cause fluid loss. So if that's the case she should expect this to be temporary, right? – Rockgrrl Aug 28 2011 at 22:08
this would be temporary. High insulin causes salt retention. Once the salt isn't kept, the extra water follows. She might want to make sure she is getting all the necessary minerals and drinking lots of water. – The Loon Aug 29 2011 at 15:30
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I went through it for a couple weeks too when I switched to paleo. I literally lost my first 10lbs due to water release. If you think about it it's quite a shock and there's a lot of detoxing going on as well. I'm no health expert but in my experience it will pass the further she gets into the paleo lifestyle. Also major Kudos for her going cold turkey of a crappy diet!

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I had the same experience. – Dragonfly Aug 29 2011 at 1:15
it took me three weeks on low carb, and then I did another major adjustment after starting the leptin reset. After a month on the reset, I could drink a glass of water right before bed and not have to wake up the whole night. – The Loon Aug 30 2011 at 15:02

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