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How Are Ketones Excreted From The Body

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 >>

Norm Of Ketone Bodies During Pregnancy

Norm Of Ketone Bodies During Pregnancy

Ketone bodies during pregnancy are another analysis that must be passed on to a future mother. Ketone bodies are in the urine, and allow you to determine how the pregnancy is, whether there is an infection in the body or everything is in order. Any woman will be useful to know why during pregnancy, so often pass urine tests, and that it can be learned. Let's consider what ketone bodies are, how they affect pregnancy, and what is their norm in the urine of a pregnant woman. Ketone bodies during pregnancy should be kept in small amounts in the urine. As a rule, the allocation of ketoids in knocks from 20 to 50 mg. In the general analysis of urine, these indicators are almost not perceptible. Therefore, every pregnant woman should take special tests to determine this indicator. The increased value of ketone bodies in urine is considered pathology, that is ketonuria. Ketone bodies during pregnancy are manifested in the event that in the female body there is an infection also, they can talk about early toxicosis. Ketone bodies poison the body of a pregnant woman with acetone, this complicates the process of bearing a baby. Jumps ketone bodies can be observed with a sharp decrease in the weight of the pregnant woman, but this is observed in the first months of pregnancy, during the period of toxicosis. Sometimes ketone bodies indicate that the pregnant woman has problems with the liver, as well as with the digestive system because of an incorrect, unbalanced diet. Continue reading >>

Reference Range

Reference Range

Acetoacetate, beta-hydroxybutyrate, and acetone are ketone bodies. In carbohydrate-deficient states, fatty-acid metabolism spurs acetoacetate accumulation. The reduction of acetoacetate in the mitochondria results in beta-hydroxybutyrate production. Beta-hydroxybutyrate and acetoacetate, the predominant ketone bodies, are rich in energy. Beta-hydroxybutyrate and acetoacetate transport energy from the liver to other tissues. Acetone forms from the spontaneous decarboxylation of acetoacetate. Acetone is the cause of the sweet odor on the breath in persons with ketoacidosis. [1, 2] Ketone bodies fuel the brain with an alternative source of energy (close to two thirds of its needs) during periods of prolonged fasting or starvation, when the brain cannot use fatty acids for energy. The reference range for ketone is a negative value, at less than 1 mg/dL (< 0.1 mmol/L). [3] 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 >>

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 >>

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 >>

Ketosis, Ketone Bodies, And Ketoacidosis – An Excerpt From Modern Nutritional Diseases, 2nd Edition

Ketosis, Ketone Bodies, And Ketoacidosis – An Excerpt From Modern Nutritional Diseases, 2nd Edition

The following text is excerpted from Lipids (Chapter 8) of Modern Nutritional Diseases, 2nd Edition. Ketone Bodies and Ketosis: Ketones are organic chemicals in which an interior carbon in a molecule forms a double bond with an oxygen molecule. Acetone, a familiar chemical, is the smallest ketone possible. It is composed of three carbons, with the double bond to oxygen on the middle carbon. Biological ketone bodies include acetone, larger ketones, and biochemicals that can become ketones. The most important of the ketone bodies are hydroxybutyrate and acetoacetate, both of which are formed from condensation of two acetyl CoA molecules. Acetone is formed from a nonenzymatic decarboxylation of acetoacetate. Ketone bodies are fuel molecules that can be used for energy by all organs of the body except the liver. The production of ketone bodies is a normal, natural, and important biochemical pathway in animal biochemistry (17, p. 577). Small quantities of ketone bodies are always present in the blood, with the quantity increasing as hours without food increase. During fasting or carbohydrate deprivation, larger amounts of ketone bodies are produced to provide the energy that is normally provided by glucose. Excessive levels of circulating ketone bodies can result in ketosis, a condition in which the quantity of circulating ketone bodies is greater than the quantity the organs and tissues of the body need for energy. People who go on extremely low-carbohydrate diets to lose a large excess of body fat usually go into a mild ketosis that moderates as weight is lost. There is no scientific evidence that a low-carbohydrate diet is capable of producing sufficient ketone bodies to be harmful. Excess ketone bodies are excreted by the kidneys and lungs. Exhaled acetone gives the brea Continue reading >>

Ketone Bodies

Ketone Bodies

The term “ketone bodies” refers primarily to two compounds: acetoacetate and β‐hydroxy‐butyrate, which are formed from acetyl‐CoA when the supply of TCA‐cycle intermediates is low, such as in periods of prolonged fasting. They can substitute for glucose in skeletal muscle, and, to some extent, in the brain. The first step in ketone body formation is the condensation of two molecules of acetyl‐CoA in a reverse of the thiolase reaction. The product, acetoacetyl‐CoA, accepts another acetyl group from acetyl‐CoA to form β‐hydroxy‐β‐hydroxymethylglutaryl‐CoA (HMG‐CoA). HMG‐CoA has several purposes: It serves as the initial compound for cholesterol synthesis or it can be cleaved to acetoacetate and acetyl‐CoA. Acetoacetate can be reduced to β‐hydroxybutyrate or can be exported directly to the bloodstream. Acetoacetate and β‐hydroxybutyrate circulate in the blood to provide energy to the tissues. Acetoacetate can also spontaneously decarboxylate to form acetone: Although acetone is a very minor product of normal metabolism, diabetics whose disease is not well‐managed often have high levels of ketone bodies in their circulation. The acetone that is formed from decarboxylation of acetoacetate is excreted through the lungs, causing characteristic “acetone breath.” 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 >>

Ketone Bodies

Ketone Bodies

Also found in: Dictionary, Thesaurus, Legal, Financial, Encyclopedia, Wikipedia. Related to ketone bodies: ketosis ketone [ke´tōn] any compound containing the carbonyl group, C=O, and having hydrocarbon groups attached to the carbonyl carbon, i.e., the carbonyl group is within a chain of carbon atoms. ketone bodies the substances acetone, acetoacetic acid, and β-hydroxybutyric acid; except for acetone (which may arise spontaneously from acetoacetic acid), they are normal metabolic products of lipid and pyruvate within the liver, and are oxidized by muscles. Excessive production leads to urinary excretion of these bodies, as in diabetes mellitus; see also ketosis. Called also acetone bodies. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. ketone bodies two products of lipid pyruvate metabolism, beta-hydroxybutyric acid and aminoacetic acid, from which acetone may arise spontaneously. Ketone bodies are produced from acetyl-CoA in the liver and are oxidized by the muscles. Excessive production leads to their excretion in urine, as in diabetes mellitus. Also called acetone bodies. Ketones, Blood and Urine Synonym/acronym: Ketone bodies, acetoacetate, acetone. Common use To investigate diabetes as the cause of ketoacidosis and monitor therapeutic interventions. Specimen Serum (1 mL) collected from gold-, red-, or red/gray-top tube. Urine (5 mL), random or timed specimen, collected in a clean plastic collection container. Normal findings (Method: Colorimetric nitroprusside reaction) Negative. Description Ketone bodies refer to the three intermediate products of metabolism: acetone, acetoacetic acid, and β-hydroxybutyrate. Even though β-hydroxybutyrate 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 >>

Urine Ketones - Meanings And False Positives

Urine Ketones - Meanings And False Positives

Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Urine Ketones article more useful, or one of our other health articles. Description Ketones are produced normally by the liver as part of fatty acid metabolism. In normal states these ketones will be completely metabolised so that very few, if any at all, will appear in the urine. If for any reason the body cannot get enough glucose for energy it will switch to using body fats, resulting in an increase in ketone production making them detectable in the blood and urine. How to test for ketones The urine test for ketones is performed using test strips available on prescription. Strips dedicated to ketone testing in the UK include[1]: GlucoRx KetoRx Sticks 2GK® Ketostix® Mission® Ketone Testing should be performed according to manufacturers' instructions. The sample should be fresh and uncontaminated. Usually the result will be expressed as negative or positive (graded 1 to 4)[2]. Ketonuria is different from ketonaemia (ie presence of ketones in the blood) and often ketonuria does not indicate clinically significant ketonaemia. Depending on the testing strips used, urine testing for ketones either has an excellent sensitivity with a low specificity, or a poor sensitivity with a good specificity. However, this should be viewed in the context of uncertainty of the biochemical level of significant ketosis[3]. Interpretation of results Normally only small amounts of ketones are excreted daily in the urine (3-15 mg). High or increased values may be found in: Poorly controlled diabetes. Starvation: Prolonged vomiting. Rapid weight loss. Frequent strenuous exercise. Poisoning (eg, with isop Continue reading >>

1 Ketones In Urine Summary

1 Ketones In Urine Summary

Ketones in urine, or ketonuria, as the name suggests, is characterized by the presence of ketones or ketone bodies in the urine. Ketones build up in the body when fat cells are burned to produce energy. This can be a dangerous condition if the amount of ketone is very high, particularly in people with diabetes who have high glucose levels. Carbohydrates, fats, and proteins are metabolized by the body for the generation of energy, which is used for various metabolic and enzymatic processes within the cells. On a priority basis, carbohydrates are always metabolized for the production of energy. This is then followed by the metabolization of fats and proteins. However, in some instances when the body starts generating high proportions of energy by metabolizing fats or fatty acids, a waste product of this activity accumulates in the body, which is called ketone bodies. This is usually associated with a lack of sugar or carbohydrates in the diet. These ketones are known to be eliminated through the kidneys. Hence, doctors usually perform urine tests to identify the presence of excessive ketones in the body. The concentration of ketone bodies in the urine under normal conditions is less than 20mg/dl. However, if this value rises to abnormal levels, it could be indicative of a condition known as ketoacidosis. Some of the common symptoms of ketonuria are: Thirst: The body loses excess fluid during the increased excretion of ketones. This leads to increased thirst. Frequent urination: The body tries to excrete accumulated ketones, which are associated with an increased urge to urinate. Nausea or vomiting: As the body tries to get rid of excess amounts of ketones through urine, it increases the excretion of salts like sodium and potassium. Low levels of sodium and potassium may l Continue reading >>

Quantitative Relationships Betweenbloodandurine Ketonelevels In Diabetic Ketosis

Quantitative Relationships Betweenbloodandurine Ketonelevels In Diabetic Ketosis

By HELEN EASTMANMARTIN AND ARNE N. WICK (From the Departments of Physiology and Medicine of the University of Southern California, and the Department of Medicine of the Los Angeles General Hospital, Los Angeles, and the Scripps Metabolic Clinic, La Jolla, California) In the study of ketosis in diabetic patients, cer- tain problems have gone largely unanswered due to the lack of sufficiently accurate methods for blood ketone determinations. With the develop- ment of blood ketone methods accurate at low as well as high blood concentrations, it has been possible to study the problems of (1) the renal threshold for the ketone bodies, and (2) the quan- titative relationship between the urinary ketone excretion and the blood ketone level. The studies to be presented summarize the re- sults obtained on (1) 13 diabetic patients in mild ketosis, produced by withdrawing insulin for 12 to 24 hours, a ketogenic diet for 12 to 24 hours, or a combination of a ketogenic diet and insulin with- drawal; and (2) 7 patients entering the Los Angeles County Hospital in moderate to severe ketosis (several in diabetic "coma"). In both types of patients, after initial levels of blood and urine ketone bodies were obtained, insulin and fluids were given as required by .the individual case, and blood and urine ketone levels were. fol- lowed until ketosis, as indicated by the qualitative urinary acetone test (modified Lange test), dis- appeared. The blood ketones 1 were determined by the Barnes-Wick (1) method, and the urine ketones by the Van Slyke (2) gravimetric method in most instances. Table I summarizes the results obtained in the diabetic patients in mild ketosis, and Table II the results in patients -in moderate to severe ketosis. Figures 1 and 2 give the clinical course, during therapy, of Continue reading >>

Ketone Bodies: A Review Of Physiology, Pathophysiology And Application Of Monitoring To Diabetes.

Ketone Bodies: A Review Of Physiology, Pathophysiology And Application Of Monitoring To Diabetes.

Abstract Ketone bodies are produced by the liver and used peripherally as an energy source when glucose is not readily available. The two main ketone bodies are acetoacetate (AcAc) and 3-beta-hydroxybutyrate (3HB), while acetone is the third, and least abundant, ketone body. Ketones are always present in the blood and their levels increase during fasting and prolonged exercise. They are also found in the blood of neonates and pregnant women. Diabetes is the most common pathological cause of elevated blood ketones. In diabetic ketoacidosis (DKA), high levels of ketones are produced in response to low insulin levels and high levels of counterregulatory hormones. In acute DKA, the ketone body ratio (3HB:AcAc) rises from normal (1:1) to as high as 10:1. In response to insulin therapy, 3HB levels commonly decrease long before AcAc levels. The frequently employed nitroprusside test only detects AcAc in blood and urine. This test is inconvenient, does not assess the best indicator of ketone body levels (3HB), provides only a semiquantitative assessment of ketone levels and is associated with false-positive results. Recently, inexpensive quantitative tests of 3HB levels have become available for use with small blood samples (5-25 microl). These tests offer new options for monitoring and treating diabetes and other states characterized by the abnormal metabolism of ketone bodies. Continue reading >>

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