Ketones — The 6 Must-knows
WRITTEN BY: Kyla Schmieg, BSN, RN Editor’s Note: Kyla Schmieg (BSN, RN) is a practicing pediatric endocrinology nurse in Cincinnati, OH, USA, and Type 1 Diabetic, working on the same unit she was diagnosed at 26 years ago. 1 – What are ketones? Ketones are chemicals that build up when your body starts to burn fat for energy. The most common cause of ketones in diabetics is insulin deficiency. Without enough insulin, glucose builds up in the blood stream and can’t enter cells. The cells then burn fat instead of glucose. This results in ketones forming in the blood and eventually spilling into urine. 2 – Why can ketones be dangerous? Having ketones can indicate that your body needs more insulin. (Always monitor your blood sugar levels to know how much insulin you need.) If you have a build up of ketones, this can lead to Diabetic Ketoacidosis (DKA). Signs of DKA include moderate or large ketones, nausea, vomiting, abdominal pain, fruity or acetone (think nail polish remover) breath, rapid breathing, flushed skin, and lack of energy. If left untreated, it can lead to a serious and life-threatening diabetic coma or death. High levels of ketones are toxic to the body and if you’re experiencing these, you should seek out medical attention. 3 – When should you check for ketones? You should be checked anytime your blood sugar is above 240 mg/dl (13.3 mmol/l) or any time you are sick. This includes any minor illness such as a cold. 4 – Can you get ketones with a high blood sugar? Ketones typically accompany high blood sugar. They indicate that your body needs more insulin. Most often if your body needs more insulin, it means you probably have a high blood sugar. Also, when an illness is present, your body releases hormones in response to the stress. These hormones Continue reading >>
A Detailed Guide On How To Test Your Ketone Levels
I have to be honest with you. I’ve been making some critical mistakes. I was assuming that I was in ketosis for months but I’m now finding out that isn’t the case. Not even close. I’ve finally hunkered down and have been measuring my ketones the right way and the results have been pretty surprising. I was eating too much protein, and too little fat. I was eating too frequently. I was eating too few calories. I never would have known this without testing. Time for you to learn from the mistakes I made and test the right way. Ketosis can be a powerful nutrition approach to use switch your metabolism to prioritize for fat loss, mental output, physical performance, and much more. The main problem? Many people just assume that if they are “low carb” they are in ketosis, but think again. How do you know if you’re actually in ketosis? As I love to say, “test, don’t guess” when it comes to your health. (Still trying to get “track, don’t slack” to catch on…) I’ll outline in this article the three ways to test your ketone levels and which you should be doing when. HOW TO TEST YOUR KETONE LEVELS: THREE DIFFERENT WAYS There are three testing methods because there are three forms of ketones in your body: acetate, acetoacetate, and beta-hydroxybutryate. Each of these ketone bodies do slightly different things and are in different forms, so they can be tested individually with different methods. The three different area these ketones exist in your body are your breath, urine or blood. The good news is that all of these ketone level measurements can be done at home, by yourself. You don’t need to go to a lab or use any fancy high-tech gadgetry. Tracking consistently, at least when you’re getting used to a ketogenic diet, is important so you know how mu Continue reading >>
Ketosis & Measuring Ketones
Generally, ketone concentrations are lower in the morning and higher in the evening. Whatever time you pick to measure ketone levels, make sure to keep it consistent. Also, do not measure your ketone levels right after exercise. Ketone levels tend to be lower while your glucose levels higher so you won't get representative numbers. Keep in mind there are daily fluctuations caused by changes in hormone levels. Don't get discouraged! Another aspect that affects the level of ketones is the amount of fat in your diet. Some of you may show higher concentration of ketones after a high-fat meal. Coconut oil contains MCTs that will help you boost ketones. To easily increase your fat intake on a ketogenic diet, try fat bombs - snacks with at least 80% fat content. Ketone levels tend to be higher after extensive aerobic exercise as your body depletes glycogen stores. Exercise may help you get into ketosis faster. ketogenic "fruity" breath is not pleasant for most people. To avoid this, drink a lot of water, mint tea and make sure you eat foods rich in electrolytes. Avoid too many chewing gums and mints, as it may put you out of ketosis; there may be hidden carbs affecting your blood sugar. Increase your electrolyte intake, especially potassium. You are likely going to lose some sodium and potassium when switching to the keto diet. Finally, if you find it hard to lose weight on a ketogenic diet, there may be plenty other reasons than the level of ketone bodies: Not Losing Weight on Low-Carb Ketogenic Diet? Don’t Give Up and Read Further. Continue reading >>
Is Ketosis Dangerous?
Duck Dodgers October 14, 2014 Peter, An article by Per Wikholm was published in this month’s LCHF Magasinet, where Per demonstrates that the Inuit could not have been in ketosis given that the scientific literature is abundantly clear, over and over again, that the Inuit consumed too much protein, and more importantly, Per debunks Stefansson’s claims for high fat with writing from his own books—Stef admitted in the pemmican recipes that Arctic caribou was too lean to make pemmican that supported ketosis. The most popular LCHF bloggers in Sweden, Andreas Eenfeldt/Diet Doctor and Annika Dahlquist have reluctantly agreed with Per’s findings—admitting that the Inuit were likely not ketogenic from their diet. I’ve put together a comprehensive review of the scientific literature regarding the Inuit, encompassing over two dozen studies, spanning 150 years, with references from explorers, including Stefansson. In the comments section of that post, Per gives a brief overview of how he was able to prove Stefansson’s observations on high fat intake were flawed. The post is a review of all the available literature that I could find (over two dozen studies). But, the literature certainly does not in any way support ketosis from the Inuit diet due to such high protein consumption. As Per (and Stefansson) points out, the caribou is too lean and as the many quotes show, the Inuit were saving their blubber and fat for the long dark Winter to power their oil lamps and heat their igloos. Again and again, we see that in the literature, as even Stefansson admits this. As far as glycogen is concerned, their glycogen intake is probably not worth scrutinizing given the well-documented high protein consumption in every published study. It really is besides the point. But, interest Continue reading >>
If you have high blood glucose levels that last for more than a few days, you could develop a condition called "ketoacidosis". This is a serious condition that can develop over several hours or a few days. People who have ketoacidosis require urgent admission to hospital for fluid and insulin therapy. When there is no insulin in your blood, glucose cannot be transported into your cells to fuel them. Your body then begins to break down its fat stores to provide an alternative source of energy to the glucose. The breakdown of fat stores produces an acidic by-product called "ketones". Ketones can be used as an alternative source of fuel to glucose. However, like glucose, they also need insulin to be used as energy for your cells. If there is no insulin in your bloodstream, the amount of ketones and glucose in your blood will rise. If ketones and glucose build up in your bloodstream, they will unbalance your blood chemistry and could be harmful. If you have high levels of ketones in your blood, you may feel very thirsty, because your body will try to flush them out through your urine. Sometimes ketones can be smelt on the breath. This smell is often described as being similar to pear drop sweets or nail varnish. When the ketones in your bloodstream continue to rise, you will start to feel nauseas and may vomit. If left untreated, ketones and blood glucose will rise even faster and could lead to a coma, which can be fatal. However, ketoacidosis can be treated, and the sooner the better to help avoid any serious health complications. Anyone who uses insulin therapy can develop ketoacidosis. This includes all people with Type 1 diabetes and some with Type 2 diabetes. In extremely rare cases, people controlling their diabetes with diet or tablets have developed ketoacidosis whe Continue reading >>
What Is High Blood Sugar?
Have you ever tried to fly a remote control airplane or helicopter? If you steer too sharply one way, your plane will crash into the ground. And if you go too far in the opposite direction, the plane will nose directly upward, making it difficult to control. For people with diabetes, controlling blood sugar levels (or blood glucose levels) is kind of like piloting that plane. To stay in the air and have the most fun, you have to keep blood sugar levels steady. Having a blood sugar level that's too high can make you feel lousy, and having it often can be unhealthy. The blood glucose level is the amount of glucose in the blood. Glucose is a sugar that comes from the foods we eat, and it's also formed and stored inside the body. It's the main source of energy for the cells of our body, and it's carried to each cell through the bloodstream. Hyperglycemia (pronounced: hi-per-gly-SEE-me-uh) is the medical word for high blood sugar levels. High blood sugar levels happen when the body either can't make insulin (type 1 diabetes) or can't respond to insulin properly (type 2 diabetes). The body needs insulin so glucose in the blood can enter the cells of the body where it can be used for energy. In people who have developed diabetes, glucose builds up in the blood, resulting in hyperglycemia. Having too much sugar in the blood for long periods of time can cause serious health problems if it's not treated. Hyperglycemia can damage the vessels that supply blood to vital organs, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems in people with diabetes. These problems don't usually show up in kids or teens with diabetes who have had the disease for only a few years. However, these health problems can occur in adulthood in some Continue reading >>
Do Ketones Burn Fat?
Many low-carb diet programs recommend that you check your levels of ketones in your urine to ensure that you burn fat. The best way to make your body utilize fat instead of sugar is by lowering your carbohydrate intake. Consuming less than 50 g of carbs a day promotes ketosis, according to the Food and Agriculture Organization of the United Nations. If you are in ketosis, it means that your body is burning fat and producing ketones. Ketones do not burn fat, but indicate that your body is in fat-burning mode. Urine Ketones You can use ketone strips to dip in your urine and determine if ketones are present in your urine. For most people eating a standard American diet, their carb intake is too high to promote ketosis and ketones cannot be detected in their urine. However, if you eat a low amount of carbs, your body will produce ketones and some of these ketones will spill out in your urine, which explains why you can verify if your are ketosis by checking your urine ketones. If your urine ketone test is positive, you know that your body is burning fat. Ketosis Vs. Ketoacidosis Many people confuse ketosis and ketoacidosis. Although both conditions are characterized by higher levels of ketones than what is usually seen in people consuming a high-carb diet and indicate that your body is burning fat, only the latter is dangerous. Ketoacidosis only occurs in diabetics treated with insulin. With ketoacidosis, their ketone levels are 5 to 10 times greater than what is seen in ketosis and people need to go to the hospital for treatment. In ketosis, which is a perfectly normal and healthy state for the human body, ketone levels are slightly elevated, but not to a dangerous level. By-Product of Fat Oxidation When your carbohydrate intake is low enough, your body starts utilizing fa Continue reading >>
Five Things To Know About Ketones
If you live with diabetes, you have probably heard that ketones are something to watch out for. That they have something to do with the dreaded diabetic ketoacidosis (DKA). But do you really understand what ketones are and why they happen? It’s scary to think about, sure. But it’s also very important to be in the know about ketones and to be prepared. 1) What are ketones? If there isn’t enough insulin in your system, you can’t turn glucose into energy. So your body starts breaking down body fat. Ketones are a chemical by-product of this process. This can occur when people with type 1 diabetes don’t take insulin for long periods of time, when insulin pumps fail to deliver insulin and the wearer does not monitor blood glucose, or during serious illness (in type 1 or type 2) when insulin doses are missed or not increased appropriately for the stress of illness. Ketones can happen to anyone with diabetes, but the condition is more common in people with type 1. 2) Why are ketones dangerous? Ketones upset the chemical balance of your blood and, if left untreated, can poison the body. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. Eventually they build up in the blood. The presence of ketones could be a sign that you are experiencing, or will soon develop, diabetic ketoacidosis (DKA)—a life-threatening medical emergency. 3) When should I test for ketones, and how? There are several situations in which it is a good idea to check for ketones, usually every four to six hours. Talk to your doctor to know what makes the most sense for you and your diabetes management plan. Your blood glucose is more than 300 mg/dl (or a level recommended by your doctor) You feel nauseated, are vomiting or have abdominal pain You are Continue reading >>
The Facts Diabetic ketoacidosis (DKA) is a condition that may occur in people who have diabetes, most often in those who have type 1 (insulin-dependent) diabetes. It involves the buildup of toxic substances called ketones that make the blood too acidic. High ketone levels can be readily managed, but if they aren't detected and treated in time, a person can eventually slip into a fatal coma. DKA can occur in people who are newly diagnosed with type 1 diabetes and have had ketones building up in their blood prior to the start of treatment. It can also occur in people already diagnosed with type 1 diabetes that have missed an insulin dose, have an infection, or have suffered a traumatic event or injury. Although much less common, DKA can occasionally occur in people with type 2 diabetes under extreme physiologic stress. Causes With type 1 diabetes, the pancreas is unable to make the hormone insulin, which the body's cells need in order to take in glucose from the blood. In the case of type 2 diabetes, the pancreas is unable to make sufficient amounts of insulin in order to take in glucose from the blood. Glucose, a simple sugar we get from the foods we eat, is necessary for making the energy our cells need to function. People with diabetes can't get glucose into their cells, so their bodies look for alternative energy sources. Meanwhile, glucose builds up in the bloodstream, and by the time DKA occurs, blood glucose levels are often greater than 22 mmol/L (400 mg/dL) while insulin levels are very low. Since glucose isn't available for cells to use, fat from fat cells is broken down for energy instead, releasing ketones. Ketones accumulate in the blood, causing it to become more acidic. As a result, many of the enzymes that control the body's metabolic processes aren't able Continue reading >>
Reasons For Ketones In Urine
What are ketones? Everybody has ketones. The body produces ketones when there is not enough insulin that will convert sugar into energy. Ketones are chemicals produced by the liver from fatty acids. The liver then sends ketones into the bloodstream, so the tissues and muscles can utilize them as fuel. People without diabetes don't have an issue with this process. However, people with diabetes can have too much buildup of ketones in the blood, which can be life-threatening. If you have type 1 diabetes, you might need a ketone test. In type 1 diabetes, a person's immune system attacks the pancreas, which produces insulin. Without enough insulin, the levels of blood sugar rise. Individuals who have type 2 diabetes can also experience high ketone levels, but not as common as with those who have type 1 diabetes. Signs to Test for Ketones Your doctor will probably ask for a ketone test when you have the following conditions: A blood sugar of more than 250 mg/dl for two consecutive days Excessive thirst Vomiting You have an illness You have an injury You are pregnant Tests for Ketones Ketones are tested through a urine analysis. You can purchase a ketone test kit at your local drugstore and test your urine at home. A ketone test can also be done in your doctor's clinic. To test for ketones in your urine, you have to pee in a sterile container to get a urine sample. After collecting the urine sample, do the following steps: Dip the test strip into the urine sample. You can also hold the strip under your urine stream. Gently shake off excess urine from the test strip. You will notice that the test strip will change in color. the directions will tell you how long that takes. Follow the instructions and check the strip color against the provided chart in your test kit. The corresp Continue reading >>
Urine Test Kits
What is the difference between the urine test kits for people with diabetes? Three different kinds of urine testing kits are available for testing three different substances in the urine: glucose (sugar), ketones, and microscopic amounts of protein (microalbuminuria). Glucose test kits Before the development of blood glucose meters, urine testing was the only method for gauging a person's sugar levels. However, it has always been a very imprecise method for testing glucose levels for a variety of reasons: Urine test strips cannot detect glucose (sugar) until the blood glucose level is above 180 mg/dl. This means a person's blood sugar level could still be high (hyperglycemia) or even dangerously low (hypoglycemia) but still not be detected. Urine glucose testing is highly subject to user error because it requires color interpretation of the urine test strip via a color-scale comparison. This becomes an issue with people who are colorblind or have poor eyesight, and certain drugs and vitamin C can change the color of the urine and thus provide an invalid measurement. The reading reflects the level of blood glucose from a few hours earlier - not at the present moment - and often is misinterpreted. As a result of these shortcomings, healthcare professionals recommend that anyone needing to closely monitor blood glucose levels use a blood glucose meter. However, urine strips can be useful in certain populations who physically cannot or will not test themselves with a blood glucose meter. Ketone test kits Ketone bodies are the byproducts of the body burning fat, rather than glucose, to provide energy. When fat is used for energy instead of glucose, the preferred fuel source, the liver produces substances called ketones. If ketones build up, they can lead to a life-threatenin Continue reading >>
Urine Test Types: Ph, Ketones, Proteins, And Cells
Urine as a Diagnostic Tool A long time ago, disgusting as it may be, people used to actually taste and drink urine in order to try and diagnose a patient's disease! I'm not even kidding you. Thankfully, modern-day doctors do not have to resort to such disgusting and even dangerous methods. One of the reasons the doctor barbers of yesteryear used to drink their patient's urine was to see if it had a sweet taste, often indicative of diabetes mellitus. Finding the sweet-tasting glucose in the urine was covered in detail in another lesson, so we'll focus on other important measurements here instead. Interpreting Urine pH One value that can be measured in the urine is known as urine pH. pH is a measure of the acidity or alkalinity of a substance. If the pH is low, then it is acidic. If the pH is high, then it is basic, or alkaline. To remember which is which, I'll give you a little trick that has worked for me. If you grew up watching cartoons, you probably saw some comical ones where cartoonish robbers poured acid on the roof of a bank vault and waited while the acid ate its way downward into the vault, so the robbers could get down there to steal all the cash. If you can recall that acid likes to eat its way downward into things, then you'll remember that acidic substances go down the pH scale. That is to say, their pH numbers are lower than basic substances. Normal urine pH is roughly 4.6-8, with an average of 6. Urine pH can increase, meaning it will become more basic, or alkaline, due to: A urinary tract infection Kidney failure The administration of certain drugs such as sodium bicarbonate Vegetarian diets On the flip side, causes for a decreased, or acidic, urine pH, include: Metabolic or respiratory acidosis Diabetic ketoacidosis, a complication of diabetes mellitus Continue reading >>
What Causes High Ketones In A Canine?
A dog with a high level of ketones in his urine suffers from a condition known as ketonuria, usually resulting from a buildup of these substances in the dog's blood. A ketone is a type of acid, which, if allowed to accumulate in the blood, can lead to ketoacidosis, a potentially fatal condition. The main health conditions that can cause high ketone levels in a canine are starvation and diabetes. A dog's body breaks down the food that he eats into sugars, also called glucose, that the cells of the body use for energy. The dog's pancreas then produces the hormone insulin to regulate the amount of glucose that the body will absorb. If the insulin to regulate the glucose is insufficient, typically due to chronic diabetes mellitus, the body breaks down alternate sources of fuel for its cells; a dog's body that is starved of nutrition will do the same. One of these sources is the fat stored in the dog's body. When the body breaks down this fat, it produces as a by-product toxic acids known as a ketones. These ketones then build up in the dog's blood and also his urine, leading to ketoacidosis. Always consult an experienced veterinarian regarding the health and treatment of your pet. A dog suffering from high ketone levels in his blood and urine exhibits symptoms of weight loss, vomiting, increased thirst, decreased appetite, increased urination, lethargy, low body temperature and yellowing of the skin and gums, according to PetMD. The dog's breath may also have a sweet, fruity smell due to the presence of acetone caused by ketoacidosis, says VetInfo. To properly diagnose high ketone levels and ketoacidosis in your dog, a veterinarian will take blood tests and a urinalysis, which will also check your dog's blood glucose levels. Depending on the dog's physical condition, hospit Continue reading >>
High Blood Glucose (hyper) & Type 1 Diabetes
Key points Hyperglycaemia happens from time to time to all people who have diabetes. Hyperglycaemia is a major cause of many of the complications that happen to people who have diabetes. For this reason, it’s important to know what hyperglycaemia is, what its symptoms are, and how to treat it. Untreated hyperglycaemia diabetes can lead to a life threatening condition called diabetic ketoacidosis (DKA). If you have Type 1 diabetes, you will often develop high blood glucose levels. Managing your Type 1 diabetes is a lot to do with developing problem solving skills and learning to use them. Remember that if your body is producing its own insulin, it alters the amount all the time (minute by minute). When you have Type 1 diabetes you have to do this consciously by using your knowledge and making sensible choices. Your diabetes nurse educator can help you learn the skills you need to do this. Some people prefer to get guidance on any of the choices they make. Everyone is different. If you are making choices you haven’t previously put into practice, get advice and support from your diabetes team before and while you make the changes. The effects of high blood glucose levels are probably what first led you to visit the doctor when your diabetes was diagnosed. Normally the human body keeps its blood glucose level very stable (between 4mmol/L – 7.5mmol/L). The body has various systems (regulated by hormones such as insulin and glucagon) for keeping the blood glucose level in this range. This doesn’t happen if you have Type 1 diabetes. Symptoms of high blood glucose levels Feeling thirsty Passing a lot of urine (you may need to get up often during the night) Feeling very tired Treatment for high blood glucose levels Try to work out why your glucose level is high. If it is Continue reading >>
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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 >>