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Starvation Acidosis

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Starvation Ketoacidosis

Eating disorders, prolonged fasting, severely calorie-restricted diets, restricted access to food (low socioeconomic and elderly patients) may be causes of starvation ketoacidosis. When insulin levels are low and glucagon levels are high (such as in a fasting state), long chain fatty acids and glycerol from triglycerides are released from peripheral fat stores and are transported to the liver. The fatty acids undergo beta-oxidation and generate acetyl-CoA. However, with excessive amounts of acetyl-CoA, the Krebs cycle may become oversaturated, and instead the acetyl-CoA enter the ketogenic pathway resulting in production of ketone bodies. Mild ketosis (1mmol/L) results after fasting for approximately 12 to 14 hours. However, the ketoacid concentration rises with continued fasting and will peak after 20 to 30 days (8-10mmol/L). Clinical Features Nausea and vomiting Abdominal pain Dehydration Altered mental status Fatigue Kussmaul breathing Differential Diagnosis Evaluation Serum chemistry (elevated anion gap) Glucose (usually euglycemic or hypoglycemic) Urinalysis (ketonuria) Serum beta-hydroxybutyrate Lactate Salicylate level (if overdose suspected) Serum osmolality (if toxic alcoh Continue reading >>

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Popular Questions

  1. bundysn

    I have been doing the Keto diet for 2.5 weeks. The first week I lost 4 lbs in 6 days. Then gained a lb and lost .6 now I'm stalled out. Basically losing .2 every few days. I AM in ketosis. I know the metallic taste, the urine smell and I test my urine in the AM before I drink water and it is at the high end of the color spectrum. My macros are 75/20/5. My energy levels are through the roof!! So no complaints there. I feel amazing!! My skin, hair etc looks better but the weight isn't coming off, even though I'm in ketosis.... Can anyone help me with this? I drink massive amounts of water. It's my addiction. At least 200 oz a day.... Always have so that's nothing new. Thanks in advance!
    Female 33
    5'8
    149

  2. Kathy13118

    Is your doctor advising you about your diet? Being in ketosis, drinking so much water, not losing weight - and continuing with the diet - I would ask your doctor what he or she thinks is going on.

  3. TattooedRN

    Since you are already at a healthy weight for your height I suspect that's why you are not losing large amounts of weight. With that said, a couple of suggestions...
    Are you eating enough fat? It has been shown that higher fat in = higher fat out.
    Also remember you can lose inches without losing pounds, this is normal and happens to everyone. Stalls are normal, they are your body's way of shifting gears and figuring out what changes are happening.
    Again, 5'8 and 149 lbs is a perfectly healthy weight and I can't see it would be very healthy for you to lose much more. Just keep at it, and if you have weight to lose, it will come off, but the less weight you have to lose the slower it will be...if your in the last 5 lbs to lose, i reiterate, it can take some time for that since your body is more likely to hold onto it. Maybe try an Atkins fat fast if that's your goal?
    Good luck!

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