I lost a stone through MS between weeks 5 - 11, although I'm gaining now baby is growing and I can eat again.
Electrolyte imbalance (the complex balance of salts in the body) can occur for a multitude of reasons. The potassium salt in particular often goes low in eating disorders (and for many other reasons too). There's a documented syndrome (albeit a little-known one) called Re-Feeding Syndrome where if you start to eat again after a prolonged episode of not eating (e.g. eating disorders, prisoners of war) your electrolytes are thrown off, particularly your phosphate salt which can go really low. They also go low in eating disorders which is probably why everyone is fretting. Your midwife is unlikely be aware of this condition although your GP may be - it's important to be excluded as management of someone not eating enough because of an eating disorder vs management of someone with an eating disorder trying to eat is very different. If you're feeling tired and cold and it was thyroid related, it would be more likely to be an underactive thyroid which would make you gain weight - however, the thyroid tests are done by the same dept. that do the electrolytes so if they're being tested, it's a simple test to add on.
I've got a really good article from the British Medical Journal (BMJ 2008;336:1495-1498 (28 June), doi:10.1136/bmj.a301) - unfortunately can't put a link as it's access via a password but here are some key extracts from it. I've edited it to translate the worst of the medical jargon.
"Refeeding syndrome can be defined as the potentially extremely serious shifts in fluids and electrolytes that may occur in malnourished patients receiving feeding. These shifts result from hormonal and metabolic changes and may cause serious clinical complications. The hallmark biochemical feature of refeeding syndrome is hypophosphataemia (a low phosphate salt). However, the syndrome is complex and may also feature abnormal sodium and fluid balance; changes in glucose, protein, and fat metabolism; thiamine (vitamin)deficiency; hypokalaemia (low potassium salt); and hypomagnesaemia (low magnesium salt).
What electrolytes and minerals are involved in the process?
Phosphorus
In refeeding syndrome, chronic whole body depletion of phosphorus occurs.
Potassium
Potassium, is also depleted in undernutrition. Again, serum (blood) concentration may remain normal.
Magnesium
Magnesium, .......can also become deficient.
Glucose (sugar)
Glucose intake after a period of starvation suppresses normal body control of blood sugars.
Vitamin deficiency
Although all vitamin deficiencies may occur at variable rates with inadequate intake, thiamine is of most importance in complications of refeeding.
Sodium, nitrogen, and fluid
Changes in carbohydrate metabolism have a profound effect on sodium and water balance. The introduction of carbohydrate to a diet leads to a rapid decrease in kidney excretion of sodium (salt) and water."
These are the current UK guidelines https://www.gserve.nice.org.uk/nicemedia/pdf/word/CG032NICEguideline.doc - around about p17 is the stuff on refeeding syndrome.
Being pregnant during/after an eating disorder is difficult as you lose a lot of control. These days, Psychiatric involvement doesn't mean you're crazy - a Psychiatrist will have a really good knowledge of eating disorders and be able to help you through this along with your GP and midwife. Have a talk with your GP who can work out how many calories you're getting in a day and give you some objective advice - and who can advise you on how many calories to aim for. 2000 in a day would be sufficient for most of us, however, if you've been malnourished you might need to reintroduce calories cautiously.
my clothes r hanging off me, and with aving twins on the way im suppost to eat an extra 300 - 600 cals more than any1 expecting a single baby! its jst not happening xx
maybe go and c her or ur doc and have a chat about it hunni xxxxxxxx
Kelly
