Alcoholic Ketoacidosis Sudden Death

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Sudden Unexplained Death In Alcohol Misuse (sudam) Patients Have Different Characteristics To Those Who Died From Sudden Arrhythmic Death Syndrome (sads)

, Volume 13, Issue3 , pp 278283 | Cite as Sudden unexplained death in alcohol misuse (SUDAM) patients have different characteristics to those who died from sudden arrhythmic death syndrome (SADS) There is growing awareness of sudden unexplained death in alcohol misuse (SUDAM) in which there is no obvious cause of death, no evidence of acute alcohol toxicity or alcoholic ketoacidosis, and the heart is morphologically normal. This study describes the characteristics of a cohort with SUDAM from a tertiary cardiovascular referral center and compares the findings with those of individuals who died from sudden arrhythmic death syndrome (SADS). Cases in this retrospective cross-sectional study were identified from a database of referrals to our center spanning approximately 40 years. Cases with recorded heavy use of alcohol and non-alcohol users were selected, then limited to those with SUDAM or SADS aged 16 to 64 years. 62 cases of SUDAM and 41 cases of SADS were identified. The SUDAM group were older than the SADS group; mean age 35.8 years and 27.7 years respectively (P=0.0002). There was also a higher incidence of significant psychiatric illness in SUDAM (19.7%) than SADS (2.4%) case Continue reading >>

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  1. [deleted]

    I am trying to get a better understanding of how you are knocked out of ketosis. I know that everyone has a carb limit that they can tolerate. For some people it is 20g and for others it is up to 50g per day or higher.
    My understanding is that once the liver refuels with a certain amount of glycogen (from carbs - or excess protein) that the liver then stops producing ketones and the body switches back to glycogen.
    If this is true, then could point loading your carbs drop you out of Ketosis (e.g you can handle 20g per day, but not 12g within thirty minutes)?
    It also makes me think that you drop out of Ketosis could happen and then you move back in relatively seamlessly as liver glycogen drops back? If this is the case, why does Dr Phinney say in his youtube video that re-adaption can take weeks once you drop out?
    https://youtu.be/KkdFkPxxDG8?t=3m38s See 3:38 - 5:10
    And is fructose is worse than glucose for halting Ketosis, because glucose can go partly into the muscles, but fructose must go via the liver?
    I guess I am trying to understand the process that leads to Ketosis pausing, and Ketosis stopping. I'm curious as to whether someone with a carb limit of 30g could handle 20g for breakfast and 20g for dinner, but not handle only a 25g lunch when no other carbs had been eaten that day. After all, the liver has no concept of what constitutes a "day"
    In general, what is it, specifically that stops ketosis, and is there a difference between temporarily halting Ketosis, and busting out (as Dr Phinney seems to indicate)?
    If this is answered elsewhere, I'd be happy with links.
    Edit u/rickamore over at r/Ketoscience provided this link, which is helpful http://ketogains.com/2015/08/will-this-kick-me-out-of-ketosis/

  2. zafic

    Carbs - doesn't matter where they are from (yes re fructose to liver - other forms of refuelling for athletic stuff doesn't apply to this sub (see link below)
    Too much protein - it's gotta be a lot compared to your protein macro though
    Doesn't matter why you stop ketosis - temporary halt or otherwise. If you leave ketosis you have to get back into it. This is why carb loading is a crap strategy for most people. Athletes who use stuff like super starch tend to use it up via their exercise but we are talking about a more specific diet.
    Carb tolerance varies - although Phinney says 50g or less it's not a hard line as some drop out at 40g or less and some can go higher (mostly athletic people)
    It would be best for you personally, with low body fat and I assume working out, to take this to /r/ketogains where people deal with this stuff all the time.

  3. [deleted]

    Thanks for the response. I get that we should just stay under our carb limit, eat moderate protein and then if that all goes bad, kCKO, but I'm looking for an understanding of the biological mechanisms that stop ketosis. Have asked it in general terms on Ketoscience as well. I found an article a while back that I meant to read, but lost. It was "What actually stops Ketosis", and was all about mitocondria and ATP or somesuch.
    Will try on Ketogains as well maybe. Be interesting to see what the CKD make of Phinney's comments re: readaptation.

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