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Alcoholic Ketoacidosis Lab Results

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Alcoholic Ketoacidosis

Alcoholic Ketoacidosis Damian Baalmann, 2nd year EM resident A 45-year-old male presents to your emergency department with abdominal pain. He is conscious, lucid and as the nurses are hooking up the monitors, he explains to you that he began experiencing abdominal pain, nausea, vomiting about 2 days ago. Exam reveals a poorly groomed male with dry mucous membranes, diffusely tender abdomen with voluntary guarding. He is tachycardic, tachypneic but normotensive. A quick review of the chart reveals a prolonged history of alcohol abuse and after some questioning, the patient admits to a recent binge. Pertinent labs reveal slightly elevated anion-gap metabolic acidosis, normal glucose, ethanol level of 0, normal lipase and no ketones in the urine. What are your next steps in management? Alcoholic Ketoacidosis (AKA): What is it? Ketones are a form of energy made by the liver by free fatty acids released by adipose tissues. Normally, ketones are in small quantity (<0.1 mmol/L), but sometimes the body is forced to increase its production of these ketones. Ketones are strong acids and when they accumulate in large numbers, their presence leads to an acidosis. In alcoholics, a combination o Continue reading >>

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Popular Questions

  1. Nick

    I'm on a ketogenic diet and have stopped taking protein shakes (excepting post-workout protein powder with water) because I've heard that it may cause an insulin spike. Is it true that protein powder with water will knock you out of ketosis? The one I'm using in particular is Optimum Nutrition Gold Standard 100% Whey.

  2. MattyP

    Yes it can.
    Protein is made up of seven different aminos, some of which (just as j.rightly correctly pointed out) can knock you out of ketosis because they are broken down into glucose in your blood.
    j.rightly is corrct. Do some research and it will confirm that protein can knock you out of keto. Anyone who says it can't doesn't understand the science behind it.
    That is why you are meant to eat about 65% of your diet from fats, 30% protein and no more than about 5% carbs (which will be incidental from your fat & protein based meals) to be sure you stay in ketosis.

  3. JoJo

    No.
    Ketosis is the deprivation of carbs. High end protein shakes, such as your ON Gold, don't contain many carbs. Thus, drinking your protein shake won't remove you from your ketogenic state. On the other hand, cheap proteins (Muscle Milk) and any protein labeled as "mass builder" will contain carbs to prevent ketosis.
    Your comment about protein shakes spiking insulin is wrong. Insulin is secreted to process sugar. Your ON Gold with water has hardly any sugar. Thus, drinking your protein shake will not spike your insulin. Insulin spikes usually only occur when you eat simple carbs from fruit, candy, etc...

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