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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56851
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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Im averaging 300 calories per day. How long can i do this

Customer Question

Im averaging 300 calories per day. How long can i do this
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. P. Jyoti replied 1 year ago.
Hello,

This is far too low an intake.

You are starving yourself.

This is very dangerous. You will be having muscle wasting. It could lead to ketosis, etc. You will feel weak, dizzy besides the possibility of having serious complications.

You may develop serious problems within a week of being on such a diet. No more than a week.

I would urge you to stop this immediately. Diet must be strictly monitored, such excessive dieting is dangerous.


Take care - hope this advise helps you and keeps you safe.

Please remember to rate my service once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!
Dr.P.Jyoti, MD.
Customer: replied 1 year ago.
I have 3+ ketones in my urine right now. It hurts my stomach to eat/drink
Expert:  Dr. P. Jyoti replied 1 year ago.
THat is very dangerous.

You must go to the ER immediately.

3+ ketones means you are having muscle wasting and your blood chemistry is altered.

You need to go to the ER immediately for this. Do not waste time. 3+ is a dangerous level of ketones and you need to be seen immediately for this.


Take care - hope this advise helps you and keeps you safe.

Please remember to rate my service once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!
Dr.P.Jyoti, MD.
Customer: replied 1 year ago.
Its not an er situation. The same thing happened last summer when i starved myself and lost 50# XXXXX less than 2 months
Expert:  Dr. P. Jyoti replied 1 year ago.
But this is very dangerous.

If at all you cannot get to the ER, then at least you must go on a normal diet immediately.

Start with a 1500 calorie diet (minimum) with balanced carbohydrates and protein.

With 3+ ketones in urine, you cannot continue this even for another day. You must stop your diet and go to at least a minimum sustenance diet. You are in a dangerous situation already.

Take care - hope this advise helps you and keeps you safe.

Please remember to rate my service once you have all the information you need. If you have any other questions, please ask me – I’ll be happy to respond. Thank you!
Dr.P.Jyoti, MD.
Customer: replied 1 year ago.
I spent all last summerwith ketones in my urine and nothing happened
Customer: replied 1 year ago.
Relist: Other.
Another opinion
Customer: replied 1 year ago.
Relist: Other.
Another opinion
Expert:  Dr. Rick, MD replied 1 year ago.
Internal medicine internship in NYC with two decades of clinical experience. I am online and available to assist you today.

While you may have done this activity last summer and gotten away with it, I agree with the other expert.....

What you are doing is very, very dangerous and can lead to death.

If you refuse to seek immediate medical help, you need to start eating the balanced diet the other expert recommended. You will loose weight on that, much more safe, diet.

Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS
Customer: replied 1 year ago.
I feel fine now though. Ive lost 4# XXXXX yesterday morning but i feel fine
Expert:  Dr. Rick, MD replied 1 year ago.
You may feel fine but with 3+ ketones in your urine, you are not OK....

Time to get medical help. Your life is not worth risking for rapid weight loss, especially when it can be done safely.


It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Customer: replied 1 year ago.
What would the er do
Expert:  Dr. Rick, MD replied 1 year ago.
Test your blood chemistry and set it back right.

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Customer: replied 1 year ago.
I will press the button. I think my ulcers are back and thats why i cant eat
Expert:  Dr. Rick, MD replied 1 year ago.
Sounds like a good idea.

I wish you the very best.

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me.
Customer: replied 1 year ago.
What are the odds that ulcers can reoccur
Expert:  Dr. Rick, MD replied 1 year ago.
Ulcers can recur. It is fairly common.

This is something the ER can take care of when they treat your ketoacidosis.

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Customer: replied 1 year ago.
What are the long term effects of ketoacidosis? This past summeri had ketones in my blood 4:1
Expert:  Dr. Rick, MD replied 1 year ago.
I thought you were going to mash the positive feedback button....

You can die from the level of ketone's you are excreting in your urine.

Just because you didn't die last summer, and you don't feel too awful terrible now, doesn't mean you are healthy or that people in your state have not died.

You are at serious risk right now. Get medical help immediately.

But not before you mash the excellent feedback button, of course. ;)
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 7963
Experience: 20+ years as a doctor. Internal Medicine Internship in NYC
Dr. Rick, MD and other Medical Specialists are ready to help you
Customer: replied 1 year ago.
What symptoms di i need to watch for
Expert:  Dr. Rick, MD replied 1 year ago.
Thank you for mashing the positive feedback button :)

The flashing red lights of the ambulance as it pulls up in your driveway to take you to the ER.

Any other course of action is not a good idea.
Customer: replied 1 year ago.
Not funny. I am being serious here
Expert:  Dr. Rick, MD replied 1 year ago.
I was not trying to be funny. I am as serious as a heart attack....

You are placing yourself at a very high risk for death by what you are doing.

3+ Ketones in your urine is a medical emergency.

You need emergency medical care.

Any other discussion is unnecessary.

And I don't know how to make you understand this fact............
Customer: replied 1 year ago.
You dont have to be a jerk about it. My pcp wasnt too worried about it.
Expert:  Dr. Rick, MD replied 1 year ago.
Then your pcp has more information then I do. I can only base my reply on what you have told me. And what you have told me is very concerning...
Customer: replied 1 year ago.
My pcp refuses to monitor my electrolytes even though i have an eatimg disorder
Expert:  Dr. Rick, MD replied 1 year ago.
Sorry to hear about that. Time to go the hospital and get emergency medical help.
Customer: replied 1 year ago.
I dont want iv fluids
Expert:  Dr. Rick, MD replied 1 year ago.
Sorry to hear that. You probably need them.
Customer: replied 1 year ago.
Im not dehydrated though. Ive been drinking lots of water
Expert:  Dr. Thomas, MD replied 1 year ago.
Hello
the other expert has opted out.
What questions remain for you
Customer: replied 1 year ago.
How long can i stay on this diet? Is 3+ ketones really that big of a deal
Expert:  Dr. Thomas, MD replied 1 year ago.
That has been answered.
You should not be on this diet at all.
It is not medically proper, it is dangerous, and more than a few days at this level of low calories should not be done.
Customer: replied 1 year ago.
What are the health consequences?
Expert:  Dr. Thomas, MD replied 1 year ago.
Many possibly life threatening consequences, the most immediate being cardiac [heart] arrhythmia[rhythm problems] due to acid base and electrolyte imbalance and this can cause death.

So, break the diet now, and get medical help immediately.

please choose a positive rating . But, still come back if you need to…think of something later, etc. Bonuses are appreciated.
Customer: replied 1 year ago.
I dont want to go to tge er
Expert:  Dr. Thomas, MD replied 1 year ago.
That is up to you, but that has to be the recommendation at this point.

I notice that you have not rated any of my answers positive.
We are not paid by JA without positive ratings.
I am glad to continue if you need to come back.
Customer: replied 1 year ago.
Whatelse can i do besides stopping the diet? I am drinking plenty of water. Could my potassium level be getting diluted?
Expert:  Dr. Thomas, MD replied 1 year ago.
There is nothing else to do.
I have already answered about the potassium, electrolytes and acid /base balance can be off, and this can affect your heart. You can not fix it on your own.
Please accept if you appreciate my work. If not, I will be glad to opt out for other experts to help you.
Customer: replied 1 year ago.
Last question then ill rate. Ive been wating just fruit. Usually 2 apples and an orange a day. Occassionally i will have a string cheese. Should i try to incorperate more protein?
Expert:  Dr. Thomas, MD replied 1 year ago.
You should add foods from all groups, whole foods, and get rapidly up to 1200 callories under supervion.

You should not try to continue dieting in any extreme way at this point.

Customer: replied 1 year ago.
That didnt really. Answer my question. Ive never ate that many calories. Should i substitue some protein for one of the apples?
Expert:  Dr. Thomas, MD replied 1 year ago.
No
you should add protein
And you should add vegetables, as well as beans, whole grains, seeds and nuts.

And you need to be under medical supervision.

please choose a positive rating . But, still come back if you need to…think of something later, etc. Bonuses are appreciated.
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56851
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
Dr. Thomas, MD and other Medical Specialists are ready to help you
Customer: replied 1 year ago.
My pcp refuses to deal with any part of my eating issue. When i spent 3 days in the hospital last summer because of my eating issues they told me my labs would have to e closely monitored and my pcp said no. In fact he gave me the choice if i wanted to go to the hospital or just get some iv fluid
Expert:  Dr. Thomas, MD replied 1 year ago.
That is not an issue that I can address, except to say get a psychiatrist.
Psychiatrists have more training in eating disorders, and your PCP should refer you to a good one.
That is the standard of care at this point.
Customer: replied 1 year ago.
Be honest with me here. How long can i live on 300-400 calories a day? As long as im drinking plenty of water
Expert:  Dr. Thomas, MD replied 1 year ago.
Hard to say, given what you have described here, ketones et al, maybe hours to days.
Maybe weeks, it depends on if you have a cardiac event or not.

Your reticence to follow the correct advise, and side track into thinking that is geared to continuing your present course, is not within the realm of normal.

It is in fact very abnormal and dangerous.

Supervision and care was needed yesterday, not tomorrow.

please choose a positive rating . But, still come back if you need to…think of something later, etc. Bonuses are appreciated.
Customer: replied 1 year ago.
I hve an eating disorder. I will always have an eating disorder
Expert:  Dr. Thomas, MD replied 1 year ago.
In fact many people get over eating disorders.

I suggest
a. Go to the ER
b. Arrange psychiatric admission if so indicated.
c. Arrange outpatient psychiatry.

That answer is not going to change.

Good luck.
Customer: replied 1 year ago.
I have a psychiatrist and a therapist
Expert:  Dr. Thomas, MD replied 1 year ago.
Good
So when you go to the ER they can contact your psychiatrist to see if inpatient admission is advised.
Customer: replied 1 year ago.
Do you really think this is an ER problem? Why is it that i was fine last summer doing this but i could die this time doing it
Expert:  Dr. Thomas, MD replied 1 year ago.
As I said, the answer is not going to change.
Customer: replied 1 year ago.
Why didnt i die last summer then
Expert:  Dr. Thomas, MD replied 1 year ago.
Luck.
As I said the answer is not going to change at this point.
No other expert is going to tell you not to go to the ER.
That is the answer.
Customer: replied 1 year ago.
You dont have to be a dink about it
Expert:  Dr. Thomas, MD replied 1 year ago.
Just trying to state the facts plainly.

If you don't like this, I am sorry, but based on your information, this is the correct answer.

IT would be unethical to suggest something else.

Good luck again.
Customer: replied 1 year ago.
If i eat can i avoid the er
Expert:  Dr. Thomas, MD replied 1 year ago.
No
There are too many problems.
As I told you before, even if you adjust the diet you need supervision, lab measurement, etc. at this point.
Customer: replied 1 year ago.
Why?
Expert:  Dr. Thomas, MD replied 1 year ago.
I am going to have to opt out if you have no new questions.
I have already answered that.
Customer: replied 1 year ago.
What problems can arise if i start eating again? You did not address that
Expert:  Dr. Thomas, MD replied 1 year ago.
The problems you already have might be too severe to be corrected just by eating.
I did explain this already.
You need supervision right now regardless.
In addition, you of course have proven that you can not handle this on your own, and you are likely to revert right back to your disorder.

Good luck
Go to the ER.

Please do not forget a positive rating.
Customer: replied 1 year ago.
Can ulcers be causing epigastric pain
Expert:  Dr. Thomas, MD replied 1 year ago.
This is a new question.
You can find me by request for new questions.

ulcers are one cause of epigastric pain, and there are many other causes.

If you would like to go into that please find me on a by request post.
You can use my name in the title.
And you can use my request link.
Right now, since we can not diagnose, this is one more symptoms that says, very plainly, go to the ER.
Which is what you should be doing at the moment.
Customer: replied 1 year ago.
Im scared. If i go to the er will they admit me?
Expert:  Dr. Thomas, MD replied 1 year ago.
I have suggested that they do need to admit you.
I have opted out of the question.
OTher experts might want to help you on this post.
Customer: replied 1 year ago.
No
Expert:  Dr. Thomas, MD replied 1 year ago.
good luck
Customer: replied 1 year ago.
Please dont opt out

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