Starvation Ketoacidosis Pathophysiology

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An Unusual Cause For Ketoacidosis

Abstract Introduction In our continuing series on the application of principles of integrative physiology at the bedside, once again the central figure is an imaginary consultant, the renal and metabolic physiologist, Professor McCance, who deals with data from a real case. On this occasion his colleague Sir Hans Krebs, an expert in the field of glucose and energy metabolism, assists him in the analysis. Their emphasis is on concepts that depend on an understanding of physiology that crosses subspecialty boundaries. To avoid overwhelming the reader with details, key facts are provided, but only when necessary. The overall objective of this teaching exercise is to demonstrate how application of simple principles of integrative physiology at the bedside can be extremely helpful for clinical decision-making (Table 1). Principle Comment 1. A high H+ concentration per se is seldom life-threatening The threat to survival is usually due to the cause for the acidosis rather than the pH per se 2. Finding a new anion means a new acid was added Look in plasma (anion gap) and urine (net charge) to identify the new anions 3. Identify the acid by thinking of the properties of the anion Rate of p Continue reading >>

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Popular Questions

  1. Becca22

    I have been in Ketosis for 5 months as of today. My color has been moderate or more (never on the light side) and I have never fallen out of ketosis in the entire 5 months.
    I am insulin resistant and I also take metformin (glumetza these days). Because of this, I have not reintroduced too many carbs back into my system. The carbs I get come from vegies and sometimes peanuts, as well as small add-ups daily (like a tablespoon of milk in my tea or maybe a tablespoon of bbq sauce on chicken).
    Overall, my carbs have been below 20 for the past 5 months and I have had NO trouble maintaining Ketosis. I feel great, have little to no cravings and I have lost about 35 lbs / possibly 40. (OMG I dont crave chinese food alllllll day long anymore ). I have encountered weeks where I was stalled - but the stall was only in the scale - I was still in ketosis, and eventually the scale moved again - without me changing the food I have been eating.
    Here's my problem.......
    this week, I notice my ketostix getting very light.... and today, pooooof! - no longer turning color!!!!! I know its not the stix (my sister uses them too).
    I have changed NOTHING. I have not "swayed towards the sugar-side", nor had any more carbs/vegies/anything more than the past 21 weeks. I prepare all my own food so I know that nothing has been different.
    WHY is this happening? I'm really bothered by it. Has anyone experienced this? How to I get the stix to change color again... I could TOTALLY drop all carbs (ummm all 15 of them?) but basically, I feel that I never really left Induction-stage anyway.
    So now someone again has suggested that the low/no carbing - ketosis is bad for my body & kidneys if I continue this way for 5 or 6 months.
    Please tell me WHY this happened,
    How do I get back in ketosis
    and regardless of what people have told me, what is YOUR experience with this being dangerous to me.

  2. LessLiz

    Relax. Your goal is to lose weight not to see color on ketostix. If your body has finally completely adapted to ketosis you will not see color as your body is using the ketones.
    Give it a week and see what your weight does. But in the meantime relax.

  3. jschwab

    If your weight continues to go down or you don't gain, no worries. You might also be better hydrated and actually still in ketosis but not have enough to show up on the strip. I see you are maybe starting your stats with your current weight when you joined, but you should put your highest weight so everyone can see your progress because you're doing great!

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