diabetestalk.net

How Are Ketones Excreted From The Body

Ketone Bodies Vijay Patel

Ketone Bodies Vijay Patel

What are Ketone bodies? How are they formed? What are there uses? What is Ketogenic diet? Toxicity. E.g. Ketosis and Ketoacidosis etc.. Ketone bodies test. Written assignment. Overview Ketone bodies are three water soluble organic molecules acetone, acetoacetic acid, and β-hydroxybutyric acid, produced by liver from fatty acids during low availability of glucose for energy. What are ketone bodies ? How are ketone bodies formed? Fatty acid metabolism- - When carbohydrates are scarce, fatty acids are broken down to acetone, acetoacetic acid, and β-hydroxybutyric acid. - Acetone is produced from acetoacetic acid on spontaneous decarboxylation. Mostly excreted in urine or expelled in a breathe giving fruity or nail polish like smell. Uses of Ketone bodies Brain fuel: Acetoacetic acid and β-hydroxybutyric acid. (Up to 60 to 70% brain fuel) Anti-oxidative and anti-inflammatory effects. Possible drug like action: Direct injection of ACA and acetone into animal models of epilepsy prevented seizures. Nutritional Ketosis for weight loss: Daily restriction of carbohydrate to below 60 grams per day. (Mild ketosis ïƒ 1 mM, prolonged fasting ketosis ïƒ 8 to 10 mM) Ketogenic diets enhances energy levels, mental clarity, and decreases hunger. Ketone bodies have shown to improve memory in patients at risk for Alzheimer’s disease, stabilize mood in type II bipolar disorder, reduce symptoms in Parkinson’s disease. Ketogenic Diet The Atkins diet is by far the most famous ketogenic diet. The diet was developed by the late Robert C. Atkins, M.D. in the late 1980s Ketosis: Rate of synthesis > rate of utilization and blood concentration of ketone bodies increased leading to ketonemia followed by excretion in urine leading to ketonauria. Overall condition is known as Continue reading >>

The Natureof Diabetic Acidosis

The Natureof Diabetic Acidosis

(From the Department of Internal Medicine of Yale University and the Medical Service of the New Haven Hospital, New Haven) Since the discovery that ketone acids are produced in the body and accumulate in the blood to excess in severe diabetes, general opinion has held that the accumulation of these chemical compounds is responsible for the syndrome known as diabetic coma. The general application of the term acidosis to the condition is in itself sufficient evidence of the importance which is attached to this disorder of metabolism. Difference of opinion seems to have been restricted chiefly to the question of the relative parts played by the ketone bodies as such and by the reduction of blood alkali and diminution of pH which they caused. In favor of direct action of the ketones have been cited the demonstrated anesthetic effects of acetone and diacetic acid, while the adherents of the acidosis theory depend upon experiments in which various workers, beginning with Walter (1)'have demonstrated the disastrous, even lethal, effects of injections of massive doses of mineral acids. With the appearance and application of accurate and practical methods for the determination of blood bicarbonate and pH it has be- come increasingly apparent that alkali deficits of the magnitude found in diabetic acidosis, when they are produced experimentally or occur in the course of other diseases, are not necessarliy attended by a syndrome resembling that of diabetic acidosis. This has, perhaps, given more weight to the arguments of those who would hold that acetone and di- acetic acid, by their anesthetic and poisonous effects, are responsible for the symptoms and fatalities. On the other hand there is but the scan- tiest positive quantitative evidence to support such a theory. The an- esth Continue reading >>

Ketones

Ketones

Excess ketones are dangerous for someone with diabetes... Low insulin, combined with relatively normal glucagon and epinephrine levels, causes fat to be released from fat cells, which then turns into ketones. Excess formation of ketones is dangerous and is a medical emergency In a person without diabetes, ketone production is the body’s normal adaptation to starvation. Blood sugar levels never get too high, because the production is regulated by just the right balance of insulin, glucagon and other hormones. However, in an individual with diabetes, dangerous and life-threatening levels of ketones can develop. What are ketones and why do I need to know about them? Ketones and ketoacids are alternative fuels for the body that are made when glucose is in short supply. They are made in the liver from the breakdown of fats. Ketones are formed when there is not enough sugar or glucose to supply the body’s fuel needs. This occurs overnight, and during dieting or fasting. During these periods, insulin levels are low, but glucagon and epinephrine levels are relatively normal. This combination of low insulin, and relatively normal glucagon and epinephrine levels causes fat to be released from the fat cells. The fats travel through the blood circulation to reach the liver where they are processed into ketone units. The ketone units then circulate back into the blood stream and are picked up by the muscle and other tissues to fuel your body’s metabolism. In a person without diabetes, ketone production is the body’s normal adaptation to starvation. Blood sugar levels never get too high, because the production is regulated by just the right balance of insulin, glucagon and other hormones. However, in an individual with diabetes, dangerous and life-threatening levels of ketone Continue reading >>

Urine - For Ketone, Ketone Bodies (ketonuria)

Urine - For Ketone, Ketone Bodies (ketonuria)

Sample The is done on the urine. Indication It is advised in diabetic patients for the early diagnosis of ketoacidosis. To evaluate the diabetic patient in a coma. Definition Increased ketone bodies in blood are called Ketonemia. Increased excretion in the urine is called Ketonuria. Pathophysiology Ketone bodies are seen in case of decreased availability of carbohydrates like starvation or frequent vomiting. Another possibility is decreased utilization of carbohydrates like diabetes mellitus, and glycogen storage disease. High fat and low carbohydrates diet are ketogenic and increase ketone bodies in the blood. Ketones are the end product of fatty acid catabolism. Ketones are formed when the glucose as a source of energy is not present. This situation happens when there is no insulin so glucose cannot enter the cells. In that case, ketone bodies are the source of energy for the body, particularly to the brain. In case of fasting for 3 to 4 days, then 30 to 40% body energy is provided by the ketone bodies. Ketones bodies are the end product of fatty acid breakdown and consists of : Beta-hydroxybutyric acid. Acetoacetic acid. Acetone. The β- hydroxybutyric acid + acetoacetic acid readily converts to acetone. In the blood: Acetone is the minor amount. Acetoacetate and β- hydroxybutyrate are equal in amount and are the main ketone bodies. in a healthy person, ketones are formed in the liver but there is a negligible amount in urine. The outcome of Increased Ketones in the blood leads to : Electrolyte imbalance. Dehydration. If not corrected then leads to acidosis coma and ultimately death. Ketones are present in the urine when a threshold level of ketones exceed the normal level in the blood. Normal In Urine Ketone bodies are negative. Small amount = < 20 mg/dL. Moderate Continue reading >>

Ketosis, Ketones, And How It All Works

Ketosis, Ketones, And How It All Works

Ketosis is a process that the body does on an everyday basis, regardless of the number of carbs you eat. Your body adapts to what is put in it, processing different types of nutrients into the fuels that it needs. Proteins, fats, and carbs can all be processed for use. Eating a low carb, high fat diet just ramps up this process, which is a normal and safe chemical reaction. When you eat carbohydrate based foods or excess amounts of protein, your body will break this down into sugar – known as glucose. Why? Glucose is needed in the creation of ATP (an energy molecule), which is a fuel that is needed for the daily activities and maintenance inside our bodies. If you’ve ever used our keto calculator to determine your caloric needs, you will see that your body uses up quite a lot of calories. It’s true, our bodies use up much of the nutrients we intake just to maintain itself on a daily basis. If you eat enough food, there will likely be an excess of glucose that your body doesn’t need. There are two main things that happen to excess glucose if your body doesn’t need it: Glycogenesis. Excess glucose will be converted to glycogen and stored in your liver and muscles. Estimates show that only about half of your daily energy can be stored as glycogen. Lipogenesis. If there’s already enough glycogen in your muscles and liver, any extra glucose will be converted into fats and stored. So, what happens to you once your body has no more glucose or glycogen? Ketosis happens. When your body has no access to food, like when you are sleeping or when you are on a ketogenic diet, the body will burn fat and create molecules called ketones. We can thank our body’s ability to switch metabolic pathways for that. These ketones are created when the body breaks down fats, creating Continue reading >>

Ketone Bodies

Ketone Bodies

Ketone bodies Acetone Acetoacetic acid (R)-beta-Hydroxybutyric acid Ketone bodies are three water-soluble molecules (acetoacetate, beta-hydroxybutyrate, and their spontaneous breakdown product, acetone) that are produced by the liver from fatty acids[1] during periods of low food intake (fasting), carbohydrate restrictive diets, starvation, prolonged intense exercise,[2], alcoholism or in untreated (or inadequately treated) type 1 diabetes mellitus. These ketone bodies are readily picked up by the extra-hepatic tissues, and converted into acetyl-CoA which then enters the citric acid cycle and is oxidized in the mitochondria for energy.[3] In the brain, ketone bodies are also used to make acetyl-CoA into long-chain fatty acids. Ketone bodies are produced by the liver under the circumstances listed above (i.e. fasting, starving, low carbohydrate diets, prolonged exercise and untreated type 1 diabetes mellitus) as a result of intense gluconeogenesis, which is the production of glucose from non-carbohydrate sources (not including fatty acids).[1] They are therefore always released into the blood by the liver together with newly produced glucose, after the liver glycogen stores have been depleted (these glycogen stores are depleted after only 24 hours of fasting)[1]. When two acetyl-CoA molecules lose their -CoAs, (or Co-enzyme A groups) they can form a (covalent) dimer called acetoacetate. Beta-hydroxybutyrate is a reduced form of acetoacetate, in which the ketone group is converted into an alcohol (or hydroxyl) group (see illustration on the right). Both are 4-carbon molecules, that can readily be converted back into acetyl-CoA by most tissues of the body, with the notable exception of the liver. Acetone is the decarboxylated form of acetoacetate which cannot be converted Continue reading >>

What Is Acetoacetate?

What Is Acetoacetate?

When following a ketogenic diet, measuring ketone levels in the body is an important part of maintaining a healthy level of ketosis. There are three types of ketones created in the body, and it’s helpful to know the different roles each type plays, both for monitoring their levels and for understanding the ketosis process. In this article, we’re zeroing in on just one of those ketone bodies: acetoacetate. So, what is acetoacetate and how exactly does it fit into ketosis? To answer that question, let’s step back outside the aquarium (so-to-speak) and review what’s happening in ketosis. What is Acetoacetate in Terms of the Ketogenic Diet For most of us, the most common source of fuel for the body is glucose, because it is readily available when we eat foods containing carbohydrates, such as breads, pastas, sugars, fruits, or starches. When we digest carbs, they either turn immediately into glucose for the body to use or are stored as glycogen within our muscles, liver, and brain. However, if there aren’t sufficient levels of carb intake, such as when someone is on a ketogenic diet (low carb, moderate protein, and high fat), the body will shift to break down fat for fuel instead. During this process, which is known as ketogenesis, ketones like acetoacetate are formed by the liver. The goal of those on the ketogenic diet it to rely on ketones as a primary fuel. There are three main types of ketone bodies that can be detected in the bloodstream during ketosis. The body creates acetoacetate first. Then, BHB is created from acetoacetate, and acetone is created spontaneously as a byproduct of acetoacetate. Acetoacetate is converted into BHB, which is the rich source of energy for the brain we care about. This process of converting fatty acids to ketone bodies is essen Continue reading >>

What Are Ketones And Are They Healthy?

What Are Ketones And Are They Healthy?

What Are Ketones and Are They Healthy? If you are up on your health news or follow anyone in the health field, you have likely heard the term ketogenic diet. The goal of the ketogenic diet is to adapt the body to utilize fat as its primary fuel source instead of sugar. The body does this by first converting fat into what are called ketones that the cells can then burn as fuel. It is at this point that I typically get asked, what are ketones? In this article, I am going to clear up any gaps, explain exactly how ketogenisis works, and why it can be so beneficial for the human body. Biological Role of Ketones For our ancestors, eating three meals a day just wasn’t a thing. Instead they would hunt and forage for the foods they could find. When there wasn’t food, they wouldn’t eat. What this means is that sometimes they would go for days at a time with no food. To sustain life during times of scarcity, the body is thought to have developed the ability to utilize fat as an alternative fuel source. In a traditional nutrition course, you would learn that sugar is the body’s primary fuel source while fat is a secondary fuel source. When sugar stores are burned up, the cells then convert to burning fat as an energy source. What we are finding out now is that fat can actually be a healthier and more sustainable source of energy. Our Society Is Full of Sugar Burners Modern day, we have an abundance of food that is available to us at all times. Most of us regularly eat three meals a day with intermittent snacking in between. This kind of frequent eating, along with an overemphasis on carb-rich and sugary foods, causes a reduced ability to burn fat. As these foods damage our bodies on a metabolic level, we actually lose the ability to produce ketones. This type of reliance on Continue reading >>

Ketone Bodies

Ketone Bodies

Sort Ketone Bodies -->Represent 3 molecules that are formed when excess acetyl CoA cannot enter the TCA Cycle -->Represents 3 major molecules: 1)Acetoacetate 2)β-Hydroxybutyrate 3)Acetone -->Normal people produces ketones at a low rate -->Are only formed in the **LIVER**(by liver mitochondria) Reactions that lead to the formation of ketone bodies (***See pwrpt***) 1)2 Acetyl CoA molecules condense to form ***Acetoacetyl-CoA -->Is catalyzed by THIOLASE -->Represent the oppostie of thiolysis step in the oxidation of fatty acids -->Represent the parent compound of the 3 ketone bodies (2)Acetoacetyl CoA then reacts with another mol. of acetyl CoA to form **HMG-CoA* (3-hydroxy-3-methylglutaryl CoA) & *CoA** -->Reaction is catalyzed by **HMG-CoA Synthetase** -->HMG-CoA has 2 fates (can either progress to form ketone bodies OR can enter the pathway of CHOLESTEROL synthesis) -->Represent the **RATE-LIMITING STEP** in the synthesis of ketone bodies (3)HMG-CoA is cleaved to form **Acetoacetate**(First major ketone; represent ~20% of ketones) & another mol. of acetyl CoA -->Catalyzed by **HMG-CoA Lyase** (4) Acetoacetae can lead to the formation of β-hydroxybutyrate (~78% of ketone bodies) & Acetone (~2% of ketone bodies) via 2 separte reactions Interrelationships of the ketone bodies from Acetoacetate (1)Formation of β-hydroxybutyrate -->Acetoacetate will be reduced to form β-hyroxybutyrate in the mitochondrial matrix of the liver cell -->Is a REVERSIBLE RXN. -->Requires 1 mol of NADH (***Dependent on the NADH/NAD ratio inside the mitochondria) -->Catalyzed by β-hydroxybutyrate dehydrogenase (2)Formation of Acetone -->A slower, **spontaneous** decarboxylation to acetone -->In **DIABETIC KETOACIDOSIS, acetone imparts a characteristic smell to the patient's breath Features of Continue reading >>

Understanding Ketone Bodies And The Role Of Raspberry Ketones

Understanding Ketone Bodies And The Role Of Raspberry Ketones

Before we delve into what raspberry ketones are, and how they work, we feel it is important to understand that ketones aren’t exclusive to red raspberries. Ketone bodies are actually a naturally occurring compound in our body. What Are Ketones? Ketone bodies are the metabolic end products of our body’s fatty acid metabolism. The liver breaks down fatty acids in our body as a way to provide us energy when blood-glucose levels are low. Ketone bodies are the by-products of this process. They become available to the body as an alternative energy source. Ketones are naturally occurring in our body, going all the way back to birth. Ketone bodies are essentially three water-soluble compounds. The liver transports two of these, acetoacetate and beta-hydroxybutyrate, to other tissues where they can be reconverted to acetyl-CoA to supply energy. The third compound, acetone, cannot be reconverted to acetyl-CoA. It is instead excreted in urine or exhaled while breathing. The Body And Energy It is commonly known that glucose (sugar), just like ketones, are another source of fuel and energy within the body. The carbohydrates that we consume in our diet ensure that glucose is present in our bloodstream. This is the first place your body will turn to when looking for fuel. The problem is the human body does not store glucose very well without consistent replenishment. This isn’t a problem for most people, since we as a nation tend to consume an unhealthy amount of sugars and carbohydrates, and don’t burn them off with sufficient exercise. In cases where glucose is less available, for instance if we engage in strenuous exercise, or we are fasting, or trying out a low-carbohydrate diet, most tissues turn to fatty acids for an additional energy source. However the human brain cann Continue reading >>

Ketosis

Ketosis

There is a lot of confusion about the term ketosis among medical professionals as well as laypeople. It is important to understand when and why nutritional ketosis occurs, and why it should not be confused with the metabolic disorder we call ketoacidosis. Ketosis is a metabolic state where the liver produces small organic molecules called ketone bodies. Most cells in the body can use ketone bodies as a source of energy. When there is a limited supply of external energy sources, such as during prolonged fasting or carbohydrate restriction, ketone bodies can provide energy for most organs. In this situation, ketosis can be regarded as a reasonable, adaptive physiologic response that is essential for life, enabling us to survive periods of famine. Nutritional ketosis should not be confused with ketoacidosis, a metabolic condition where the blood becomes acidic as a result of the accumulation of ketone bodies. Ketoacidosis can have serious consequences and may need urgent medical treatment. The most common forms are diabetic ketoacidosis and alcoholic ketoacidosis. What Is Ketosis? The human body can be regarded as a biologic machine. Machines need energy to operate. Some use gasoline, others use electricity, and some use other power resources. Glucose is the primary fuel for most cells and organs in the body. To obtain energy, cells must take up glucose from the blood. Once glucose enters the cells, a series of metabolic reactions break it down into carbon dioxide and water, releasing energy in the process. The body has an ability to store excess glucose in the form of glycogen. In this way, energy can be stored for later use. Glycogen consists of long chains of glucose molecules and is primarily found in the liver and skeletal muscle. Liver glycogen stores are used to mai Continue reading >>

Ketosis

Ketosis

Dr Robert Atkins viewed ketosis as a "metabolic advantage" to weight loss. I'm of normal weight with a Body Mass Index just under 25 (over 25 is a worry), and the advantage of ketosis for me is the stability and ease of control it confers on my blood sugar, the protection from hypoglycemia it affords (because almost all tissues can burn ketones as well as glucose), and the fact it improves my "hypoglycemic awareness" - I know when I'm "low." Briefly, the body naturally turns to fat for fuel when carbohydrate isn't available. When a lot of fat is burned, some of the fat fragments - ketones - get excreted to preserve the body's acid-base balance (because ketones are acid), and this is called "ketosis." The excreted ketones have about 5 calories per gram, and since you can excrete quite a lot of ketones, Dr Atkins' dubbed this a "metabolic advantage." Let's look at ketosis in more detail: When my blood sugar drops after a low-carbohydrate meal, the hormone glucagon is released which causes triglycerides to be released from my body's store of fat. Glucagon also causes the liver to break the triglycerides into glycerol and free fatty acids ... The glycerol part of the triglyceride provides about 7% of the fat calories as glucose, but this is not enough to maintain my blood sugar level. The balance comes from the breakdown of protein from the food I've eaten. Meanwhile, the free fatty acids are cut into two- and four-carbon fragments called ketones or ketone bodies. Ketones are normally present in the bloodstream, but when their concentration exceeds 70 mg/dl, they start to appear in the urine - this is "ketosis." Ketone bodies are the preferred fuel of the heart, adrenal cortex, skeletal musculature and various parts of the brain; these tissues actually prefer to burn ketone Continue reading >>

Ketone Bodies Metabolism

Ketone Bodies Metabolism

1. Metabolism of ketone bodies Gandham.Rajeev Email:[email protected] 2. • Carbohydrates are essential for the metabolism of fat or FAT is burned under the fire of carbohydrates. • Acetyl CoA formed from fatty acids can enter & get oxidized in TCA cycle only when carbohydrates are available. • During starvation & diabetes mellitus, acetyl CoA takes the alternate route of formation of ketone bodies. 3. • Acetone, acetoacetate & β-hydroxybutyrate (or 3-hydroxybutyrate) are known as ketone bodies • β-hydroxybutyrate does not possess a keto (C=O) group. • Acetone & acetoacetate are true ketone bodies. • Ketone bodies are water-soluble & energy yielding. • Acetone, it cannot be metabolized 4. CH3 – C – CH3 O Acetone CH3 – C – CH2 – COO- O Acetoacetate CH3 – CH – CH2 – COO- OH I β-Hydroxybutyrate 5. • Acetoacetate is the primary ketone body. • β-hydroxybutyrate & acetone are secondary ketone bodies. • Site: • Synthesized exclusively by the liver mitochondria. • The enzymes are located in mitochondrial matrix. • Precursor: • Acetyl CoA, formed by oxidation of fatty acids, pyruvate or some amino acids 6. • Ketone body biosynthesis occurs in 5 steps as follows. 1. Condensation: • Two molecules of acetyl CoA are condensed to form acetoacetyl CoA. • This reaction is catalyzed by thiolase, an enzyme involved in the final step of β- oxidation. 7. • Acetoacetate synthesis is appropriately regarded as the reversal of thiolase reaction of fatty acid oxidation. 2. Production of HMG CoA: • Acetoacetyl CoA combines with another molecule of acetyl CoA to produce β-hydroxy β-methyl glutaryl CoA (HMC CoA). • This reaction is catalyzed by the enzyme HMG CoA synthase. 8. • Mitochondrial HMG CoA is used for ketogenesis. Continue reading >>

Ketone Body Metabolism

Ketone Body Metabolism

Ketone body metabolism includes ketone body synthesis (ketogenesis) and breakdown (ketolysis). When the body goes from the fed to the fasted state the liver switches from an organ of carbohydrate utilization and fatty acid synthesis to one of fatty acid oxidation and ketone body production. This metabolic switch is amplified in uncontrolled diabetes. In these states the fat-derived energy (ketone bodies) generated in the liver enter the blood stream and are used by other organs, such as the brain, heart, kidney cortex and skeletal muscle. Ketone bodies are particularly important for the brain which has no other substantial non-glucose-derived energy source. The two main ketone bodies are acetoacetate (AcAc) and 3-hydroxybutyrate (3HB) also referred to as β-hydroxybutyrate, with acetone the third, and least abundant. Ketone bodies are always present in the blood and their levels increase during fasting and prolonged exercise. After an over-night fast, ketone bodies supply 2–6% of the body's energy requirements, while they supply 30–40% of the energy needs after a 3-day fast. When they build up in the blood they spill over into the urine. The presence of elevated ketone bodies in the blood is termed ketosis and the presence of ketone bodies in the urine is called ketonuria. The body can also rid itself of acetone through the lungs which gives the breath a fruity odour. Diabetes is the most common pathological cause of elevated blood ketones. In diabetic ketoacidosis, high levels of ketone bodies are produced in response to low insulin levels and high levels of counter-regulatory hormones. Ketone bodies The term ‘ketone bodies’ refers to three molecules, acetoacetate (AcAc), 3-hydroxybutyrate (3HB) and acetone (Figure 1). 3HB is formed from the reduction of AcAc i Continue reading >>

Why I Stopped Testing My Ketones On A Ketogenic Diet

Why I Stopped Testing My Ketones On A Ketogenic Diet

On measuring Ketones. Like many people, when I first started a Ketogenic diet in early 2014 I bought the Ketostix and just couldn’t wait to see the color change. And change it did! It was neat, and it provided motivation for me to continue. Eventually, I got a blood meter, a breath meter and spent lots of time (and money) testing ketones. Between a Ketonix Breath Ketone Analyzer, as well as dozens of blood ketone test strips, I’ve probably spent well over $500 testing ketones. The main thing I learned from my extensive ketone testing regimen is that the results vary widely and there’s little application to my goals. Eventually, I stopped testing and here are several reasons why: 1. Burning fatty acids from fat is the main benefit of a ketogenic diet On a ketogenic diet, some of the brain’s energetic demand is fueled by ketones, but the heart, muscles, etc. are fueled by fatty acids. Most of the energy we utilize both at rest and at sub-maximal exertion on a ketogenic diet is fatty acid, not ketones. Quoting Dr. Ron Rosedale on chasing ketones at the Keto Summit: “I don’t want people to have the mindset that it’s the ketones that are the benefit of the diet. They are a beneficial side effect, but the main benefit is that you are burning fatty acids from fat. The more fatty acids from fat you are burning, the less glucose you need to burn. And that’s really where you are getting the benefit…So ketones are great but the term ketogenic diet indicating that the diet is so good because you are generating all these ketones is a misinterpretation of the benefit. The main benefit is that you are burning fatty acids, and as a side effect of burning fatty acids you are producing ketones that your body can burn too!” 2. Urine Ketones aka “peetones” are ridic Continue reading >>

More in ketosis