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Nutritional Ketosis Vs Ketoacidosis

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Print Overview Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones. The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) — a major source of energy for your muscles and other tissues — enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated. If you have diabetes or you're at risk of diabetes, learn the warning signs of diabetic ketoacidosis — and know when to seek emergency care. Symptoms Diabetic ketoacidosis signs and symptoms often develop quickly, sometimes within 24 hours. For some, these signs and symptoms may be the first indication of having diabetes. You may notice: Excessive thirst Frequent urination Nausea and vomiting Abdominal pain Weakness or fatigue Shortness of breath Fruity-scented breath Confusion More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include: High blood sugar level (hyperglycemia) High ketone levels in your urine When to see a doctor If you feel ill or stressed or you've had a recent illness or injury, check your blood sugar level often. You might also try an over-the-counter urine ketones testing kit. Contact your doctor immediately if: You're vomiting and unable to tolerate food or liquid Your blood sugar level is higher than your target range and doesn't respond to home treatment Your urine ketone level is moderate or high Seek emergency care if: Your blood sugar level is consistently higher than 300 milligrams per deciliter (mg/dL), or 16.7 mill Continue reading >>

Is There A Dark Side Of Ketosis?

Is There A Dark Side Of Ketosis?

I can’t remember what appetizer she pointed to, but the woman sitting to the left of me said this so casually, and several folks at the table knew exactly what she meant, confirming what I’d long suspected: Ketogenic diets have officially gone mainstream – or recognizable at a party mainstream at least – in 2017. Let’s back up and demystify ketosis, which simply means you’re utilizing ketone bodies – more commonly called ketones – rather than glucose as your body’s primary fuel. Just like your car uses gasoline, your body needs fuel. That usually means glucose. But let’s say you’re on a very-low carbohydrate, higher-fat diet. Your body doesn’t get a lot of glucose, which primarily comes from carbohydrate and to a lesser degree protein. That means your liver’s backup glucose (glycogen) also becomes in short supply. Unlike your car, your body doesn’t just shut down. Thankfully, you have an alternative fuel source called ketones. Ketones are organic compounds your liver always makes. You’re cranking out ketones right now as you read this. During starvation or (more likely) when you restrict carbohydrate and increase fat intake, your body uses ketones as its primary fuel. In other words, when your body doesn’t receive or can’t make enough glucose, it shifts to this alternative fuel. Almost every organ can utilize ketones except for your red blood cells (which don’t have ketone-metabolizing mitochondria) and liver. Your liver, in fact, does the heavy lifting. This hardworking organ metabolizes fat into three ketone bodies: acetoacetate (ACA), beta-hydroxybutyrate (BHB), and acetone.(1) BHB is the first substrate that kicks ketosis into action. Among its benefits, BHB reduces chronic inflammation and restores healthy inflammation levels. In Continue reading >>

Ketoacidosis

Ketoacidosis

Nutritional ketosis is a normal, physiological response to carbohydrate and energy restriction. A ketogenic diet is an effective weight loss strategy for many. Ketoacidosis, on the other hand, is a pathological condition caused by insulin deficiency. The common theme is low insulin; however, in ketoacidosis, blood glucose levels are very high. Ketone levels are elevated in both states, although are 10-20x higher in ketoacidosis (~0.5-2 vs. > 20 mM). Nutritional ketosis and ketoacidosis should not be confused with one another, and a ketogenic diet doesn’t cause ketoacidosis. In ketoacidosis, gluconeogenesis occurs at a very high rate and the lack of insulin prevents glucose disposal in peripheral tissues. Skeletal muscle protein breakdown contributes gluconeogenic substrates, exacerbating the problem. This can cause blood glucose to reach pathological levels, exceeding 250 mg/dL. Brownlee, 2005 (technically, this figure shows the theoretical mechanisms underlying the pathology of the long-term effects of moderate hyperglycemia [<180 mg/dL]; not the acute effects seen in ketoacidosis…) In people on a ketogenic diet, blood glucose levels are not increased. This is an important aspect differentiating nutritional ketosis from ketoacidosis. Yes, gluconeogenesis is modestly elevated to partially compensate for the reduced carbohydrate intake… it only partially compensates for the reduced carbohydrate intake because some tissues decrease their glucose utilization, relying in fats and ketones instead (ie, less glucose is ‘needed’). From: Sumithran & Proietto, 2008 Ketone bodies are produced when glycolysis is low & hepatic fatty acid oxidation is high. Low glycolysis is important because certain byproducts of glucose metabolism inhibit fatty acid oxidation; eg, citrate Continue reading >>

Ketones In Urine – How To Test And What Levels Are Optimal

Ketones In Urine – How To Test And What Levels Are Optimal

There are likely two reasons you want to test the ketone levels in your urine: REASON 1 – you’ve got type one diabetes (or type two diabetes, in some cases) and you need to test the ketones levels in your urine to help you avoid ketoacidosis. If that’s the case, skip down to the sections on… Then, skip straight to the section on… REASON 2 – you’re on the Keto diet and you want to use urine strips to check if you’re in ketosis. If that’s the case, then don’t worry we’ll also cover: But skip the section on ketoacidosis – it doesn’t apply to you unless you’re diabetic! Note that information contained in this article (and website) is not intended to and shall not convey or recommend any medical or nutritional advice or course of action. Any diet, health, or nutritional program you undertake should be discussed with your doctor or other licensed medical professionals. All opinions expressed in this article are based solely on personal experiences and research. We are NOT licensed doctors, dietitians, or nutritionists. Testing Laboratory Microbiology - Air Quality - Mold Asbestos - Environmental - Lead emsl.com What are ketones? First things first – a quick 101 intro on what ketones actually are: Ketone bodies (or ketones) are produced by your liver during the break down of fatty acids when your body is low on glucose. Your body then uses these ketone bodies as fuel. You see, your cells can’t directly use the fatty acids in your fat stores to produce energy. And that’s because those fatty acids are unable to pass through the membrane which surrounds your cells. And if they can’t get inside? They can’t be used as fuel. So there’s an extra step to the process: First, the fatty acids travel to your liver where they’re broken down into ke Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

A Preventable Crisis People who have had diabetic ketoacidosis, or DKA, will tell you it’s worse than any flu they’ve ever had, describing an overwhelming feeling of lethargy, unquenchable thirst, and unrelenting vomiting. “It’s sort of like having molasses for blood,” says George. “Everything moves so slow, the mouth can feel so dry, and there is a cloud over your head. Just before diagnosis, when I was in high school, I would get out of a class and go to the bathroom to pee for about 10–12 minutes. Then I would head to the water fountain and begin drinking water for minutes at a time, usually until well after the next class had begun.” George, generally an upbeat person, said that while he has experienced varying degrees of DKA in his 40 years or so of having diabetes, “…at its worst, there is one reprieve from its ill feeling: Unfortunately, that is a coma.” But DKA can be more than a feeling of extreme discomfort, and it can result in more than a coma. “It has the potential to kill,” says Richard Hellman, MD, past president of the American Association of Clinical Endocrinologists. “DKA is a medical emergency. It’s the biggest medical emergency related to diabetes. It’s also the most likely time for a child with diabetes to die.” DKA occurs when there is not enough insulin in the body, resulting in high blood glucose; the person is dehydrated; and too many ketones are present in the bloodstream, making it acidic. The initial insulin deficit is most often caused by the onset of diabetes, by an illness or infection, or by not taking insulin when it is needed. Ketones are your brain’s “second-best fuel,” Hellman says, with glucose being number one. If you don’t have enough glucose in your cells to supply energy to your brain, yo Continue reading >>

Does Ketosis Cause Kidney Damage?

Does Ketosis Cause Kidney Damage?

The ‘Lean for Life’ program is mildly ketotic, and only for a brief portion of the program. It has not been associated with kidney damage or disease in individuals who have normally functioning kidneys. Concerns regarding undue stress on the kidneys are often aimed at very low carbohydrate, very high protein ketogenic diets. Few studies have shown any actual damage, however. (Note: Although the Weight Loss portion of the ‘Lean for Life’ program is mildly ketogenic, it is not considered to be exceptionally “high protein” for most individuals.) Dietary ketosis is among the most maligned and misunderstood concepts in nutrition medicine. Particularly among researchers who don’t actually treat patients, ketosis (the presence of ketone bodies in the urine) is often confused with ketoacidosis, which is a life-threatening build-up of ketone bodies due to muscle wasting and dehydration as in states of shock or uncontrolled Type 1 diabetes. In the Type 1 diabetic, the absence of insulin leads to a toxic build-up of blood glucose and an extreme break-down of fat and muscle tissue. This condition doesn’t occur in individuals who have even a small amount of insulin, whether from natural production or artificially administered. Whereas patients in ketoacidosis are closely monitored in Intensive Care Units, individuals in ketosis are amongst the healthy, active population. Dietary ketosis is a natural adjustment to the body’s reduced intake of carbohydrates as the body shifts its primary source of energy from carbohydrates to stored fat. The presence of insulin keeps ketone production in check so that a mild, beneficial ketosis is achieved. Blood glucose levels are stabilized within a normal range and there is no break-down of healthy muscle tissue. It would be diffi Continue reading >>

Keto Diet Mastery: Your Comprehensive Guide To The Ketogenic Diet

Keto Diet Mastery: Your Comprehensive Guide To The Ketogenic Diet

What if you could train your body to burn fat more efficiently and speed up your metabolism without restricting calories? If you’re struggling to lose those last 5 pounds or wondering why the muffin top just won’t budge (despite eating clean and exercising), you may find the answers you’re looking for in this keto diet master guide. What Is the Keto Diet? The ketogenic (aka: “keto”) diet is a high-fat, low-carb diet that puts your body in a natural fat-burning metabolic state called ketosis (1). This is done by heavily restricting carbs and focusing on high fat, moderate protein meals (in some cases protein may be also be heavily restricted). According to PubMed, the classical ketogenic diet contains a 4:1 ratio of fat to proteins and carbs. In other words, the principle of the keto diet is to “eat fat to burn fat”. Now, the keto diet is often grouped with other high-fat, low-carb diets such as the Paleo or Atkins diets. But the reason these diets boast fat burning benefits in the first place is because they promote ketosis. Therefore, the ketogenic diet isn’t so much a “diet”, but more so the basis of these diets, and the biochemical reaction that occurs when you train your body to burn fat for fuel instead of carbs. While the ketogenic diet has become popular for weight loss, studies have also shown numerous other health benefits of following a keto diet. For example, studies have shown it may help reverse type 2 diabetes and reduce symptoms of Alzheimer’s disease, depression, and autism (2)(3). In fact, the keto diet was first used in the 1920s not as a weight loss diet, but a natural treatment to prevent seizures in epilepsy patients (4). With that said, let’s look closer at how the ketogenic diet can work for dramatic weight loss, and other Continue reading >>

Type 1 Diabetes

Type 1 Diabetes

Certainly a low carb approach doesn’t work with Type 1’s, right? What about the dangerous risks of hypoglycemia? Actually, this thinking is repeated over and over. Nothing could be further from the truth. In fact, those using a low carbohydrate high healthy fat (LCHF) approach have much more stable blood sugars, some nearly eliminating hypoglycemic episodes altogether. It really makes perfect sense. Why this reasoning is shunned, defies logic. Think about it…less (fast acting, blood-sugar-spiking) carbs, less insulin, less hypos. Before we go further in this post, I’d like you to read this powerfully compelling account of Dr. Keith Runyan, MD, a Nephrologist, who is a Type 1, and who successfully uses a carb restricted approach to manage his diabetes. Please read his story (link below). There is no way I could do this story justice in fewer words. The entire article is needed to understand its full impact. Afterwards, I would recommend his accompanying video. Nutritional Ketosis vs Diabetic Ketoacidosis Much of the backlash from mainstream beliefs regarding the use of carb restriction with Type 1’s stems from the lack of understanding about the difference between nutritional ketosis and diabetic ketoacidosis. I’m going to quote directly from Diabetes Daily Website. Here is the content of their article entitled “Why DKA and Nutritional Ketosis Are Not The Same”…(read the full article HERE) “There’s a very common misconception and general misunderstanding around ketones. Specifically, the misunderstanding lie in the areas of: ketones that are produced in low-carb diets of generally less than 50g of carbs per day, which is low enough to put a person into a state of “nutritional ketosis.” ketones that are produced when a diabetic is in a state of Continue reading >>

Type 1 Diabetes Vs Type 2 Diabetes

Type 1 Diabetes Vs Type 2 Diabetes

Type 1 Diabetes and Type 2 Diabetes: Similar Name but Completely Different Diseases. As a healthcare professional, I see widespread confusion between Type 1 Diabetes Mellitus (T1 DM) and Type 2 Diabetes Mellitus (T2 DM) among patients, healthcare providers, and the lay public. Because of this, I have decided to use my platform to help explain the difference between these two very different conditions. Much of the confusion between the two conditions comes from the similar name and the similar manifestation of elevated blood glucose levels. The goal of treatment in both conditions is to keep blood glucose levels within normal range. However, because they do not result from the same root cause, treatment, management, and education should be approached differently between the two. What is Type 1 Diabetes? First and foremost, T1 DM is an autoimmune disease. Although there are a few hypotheses about the potential causes of autoimmunity, T1 DM is not preventable. It is usually diagnosed in childhood, but can occur in adulthood as well. Onset is usually rapid and acute. Classic symptoms of T1 DM are polydipsia (excessive thirst), polyphagia (excessive hunger), polyuria (excessive urination), weight loss, dry mouth, and fatigue. If untreated, T1 DM can lead to Diabetic Ketoacidosis (not nutritional ketosis), which can be fatal. Signs and symptoms of DKA (in addition to those listed above) are dry mouth, lethargy, abdominal pain, vomiting, and coma. These symptoms warrant a trip to the ER. T1 DM is ultimately confirmed by an autoimmune antibody test. The most important difference between T1 DM and T2 DM (I think), is that T1 diabetics and insulin DEFICIENT whereas T2 diabetics produce TOO MUCH insulin leading to insulin resistance. What does this mean? Insulin often gets a bad r Continue reading >>

The Ketogenic Diet And Type 1 Diabetes

The Ketogenic Diet And Type 1 Diabetes

What is type 1 diabetes? How is it different than type 2? Type 2 diabetes is a condition where the body becomes resistant to insulin, forcing the pancreas to produce ever more insulin, and leading to a downward spiral of metabolic illness. It’s also called “Adult Onset Diabetes”, because the vast majority of people who develop it do so in adulthood, after years of eating a high-carb diet. Type 1 diabetes, also known as “Juvenile Diabetes”, is a disorder where the body’s immune system attacks the cells of the pancreas responsible for producing insulin. Only the pancreas can produce insulin, and insulin is the hormone primarily responsible for shuttling molecules out of the blood and into cells for energy or storage. That means, if the pancreas isn’t producing insulin, a person will starve to death from the inside. Their cells, literally, cannot get any food. They can eat and eat and eat, but there’s no mechanism to transport that food energy into the cells. That’s why they need regular insulin shots. On a regular-carb diet, those insulin shots might be several times per day. On a high-carb diet, those shots will be even more frequent. Type 1 diabetics must keep injecting themselves with insulin in order to deal with all the glucose in their blood stream. They have to keep insulin levels high, if they eat high carbs, because they have a high level of glucose to deal with. Being ketogenic means insulin levels don’t have to be high, because there isn’t a high level of glucose that needs to be shuttled around. And, because there isn’t a big requirement for insulin, the type 1 diabetic can reduce the amount of insulin needed on a daily basis (many reduce this requirement by 80%). The important thing to remember is that someone suffering from type 1 dia Continue reading >>

Ketosis Vs Ketoacidosis

Ketosis Vs Ketoacidosis

Ketosis vs ketoacidosis: Are they both safe? What’s the difference between them. You may have read warnings about the dangers of putting your body into ketosis. Often , the danger of having ketones in the blood is limited to those who have pre-existing metabolic disorders. When you’re following a very low-carb diet, you’ll experience dietary ketosis. Ketosis is a natural physiological state where your body starts burning fat for energy when glucose isn’t easily available and you body has depleted its glycogen stores. This is a normal metabolic process, with a number of proven health benefits ranging from weight loss to managing seizures to improving symptoms of degenerative diseases like Alzheimer’s or Parkinson’s. It’s also the basis of low-carb diets like keto, paleo, and Atkins. However, those with Type 1 Diabetes can sometimes produce excessive amounts of ketone bodies, the compounds that your body creates when you’re metabolizing fats. The boost in the amount of ketones in the blood can be dangerous when a couple of other factors are also present. The result is a life-threatening condition called ketoacidosis. It’s important for you to know the difference between nutritional ketosis and diabetic ketoacidosis. What is Nutritional Ketosis? Studies have proven that ketone body metabolism can provide natural relief from symptoms associated with a variety of health issues, and can result in a significant reduction in body fat. Ketosis can even help decrease your appetite and support lean muscle mass, which are just a couple of the important benefits available to people who follow a low-carb diet. Nutritional ketosis is the body’s natural response to the low-carb diet. Any time you slash your carbs and keep them under 50g to 70g a day then replace tho Continue reading >>

What Is The Difference Between Ketosis And Ketoacidosis?

What Is The Difference Between Ketosis And Ketoacidosis?

Ketoacidosis is a dangerous condition, where toxic levels of ketone bodies build up in the blood because the body is not producing insulin. Ketosis, on the other hand, results when the body has exhausted its stored glycogen and begins to burn fatty tissue for energy. Ketosis The process of ketosis is the basis of the many low-carb diets marketed to the public. In ketosis, the body does not have sufficient glucose or glycogen available to give cells what they need to create energy. The body then turns to fat cells as an energy source. Ketone bodies in the bloodstream are a natural product of this process. These diets work, and ketosis is achieved, when carbohydrates are essentially eliminated from the diet. With minimal carbohydrate intake, there is little sugar to convert to glycogen. Without glycogen, the body breaks down and excretes fat cells, leaving ketones behind in the blood. In an ideal situation, this results in weight loss. Ketones in the body can be toxic in high enough concentrations. The body often has small amounts of ketones in the bloodstream, including during the overnight period. This is a mild, natural reaction, with low levels of ketones (blood ketones at 1-3 millimolar) and a normal pH of 5, that reverses in the morning when the nightly fast is broken. Low levels of ketones in the bloodstream do not represent a danger to health. Ketoacidosis Ketoacidosis occurs when blood sugar levels are high (meaning they are not being metabolized properly in the absence of insulin) and the body is experiencing dehydration. This means the normally small concentration of ketones in the bloodstream becomes much larger. Ketoacidosis is a pathological condition where the body cannot control the level of ketones building up in the blood. The ketones are being excreted Continue reading >>

Nutritional Ketosis, Treating Type 2 Diabetes And Morea Q&a With Dr. Stephen Phinney

Nutritional Ketosis, Treating Type 2 Diabetes And Morea Q&a With Dr. Stephen Phinney

Nutritional Ketosis, Treating Type 2 Diabetes and MoreA Q&A with Dr. Stephen Phinney Is type 2 diabetes reversible? Is intermittent fasting good for you or dangerous? Is nutritional ketosis possible for vegetarians? Virta co-founder and Chief Medical Officer Dr. Stephen Phinney answers these questions and a lot more in this Q&A. Thanks again to everyone who joined our recent Facebook Live session with Dr. Phinney and for submitting great questions. Well be doing it again soon, and well announce our next live event on Virtas Facebook page . In the mean time, Dr. Phinney took it upon himself to answer many of the questions that didnt get answered. If you dont see your question, it was probably answered live. Enjoy! Q: Interested in reversing type 2 diabetes is a ketogenic diet recommended?? Thx! Dr. Phinney: Insulin resistance is the hallmark of type 2 diabetes and manifests as carbohydrate intolerance. Like other food intolerances, the most logical and effective approach to managing carbohydrate intolerance is to restrict sugars and starches to within the individuals metabolic tolerance. A well-formulated ketogenic diet can not only prevent and slow down progression of type 2 diabetes, it can actually resolve all the signs and symptoms in many patients, in effect reversing the disease as long as the carbohydrate restriction is maintained. Q: Appreciated your article on the concerns about prolonged fasting. Could you comment on the utility and safety of shorter durations of fasting (i.e. 16 hrs of fasting/8 hrs of eating or 20 hrs of fasting/4 hrs of eating over a period of 1 day)? Dr. Phinney: I do not have major concerns with either time-restricted feeding or intermittent fasting for durations less than 24 hrs as long as: There are adequate protein and vegetable intake Continue reading >>

What Is Ketosis?

What Is Ketosis?

"Ketosis" is a word you'll probably see when you're looking for information on diabetes or weight loss. Is it a good thing or a bad thing? That depends. Ketosis is a normal metabolic process, something your body does to keep working. When it doesn't have enough carbohydrates from food for your cells to burn for energy, it burns fat instead. As part of this process, it makes ketones. If you're healthy and eating a balanced diet, your body controls how much fat it burns, and you don't normally make or use ketones. But when you cut way back on your calories or carbs, your body will switch to ketosis for energy. It can also happen after exercising for a long time and during pregnancy. For people with uncontrolled diabetes, ketosis is a sign of not using enough insulin. Ketosis can become dangerous when ketones build up. High levels lead to dehydration and change the chemical balance of your blood. Ketosis is a popular weight loss strategy. Low-carb eating plans include the first part of the Atkins diet and the Paleo diet, which stress proteins for fueling your body. In addition to helping you burn fat, ketosis can make you feel less hungry. It also helps you maintain muscle. For healthy people who don't have diabetes and aren't pregnant, ketosis usually kicks in after 3 or 4 days of eating less than 50 grams of carbohydrates per day. That's about 3 slices of bread, a cup of low-fat fruit yogurt, or two small bananas. You can start ketosis by fasting, too. Doctors may put children who have epilepsy on a ketogenic diet, a special high-fat, very low-carb and protein plan, because it might help prevent seizures. Adults with epilepsy sometimes eat modified Atkins diets. Some research suggests that ketogenic diets might help lower your risk of heart disease. Other studies show sp Continue reading >>

Is Ketosis Dangerous? No, Because Ketosis Is Not Ketoacidosis.

Is Ketosis Dangerous? No, Because Ketosis Is Not Ketoacidosis.

At this point, I consider myself pretty immune to what internet trolls say to me. I have a pretty tough skin, usually laugh off nonsensical comments, and carry on with my day. This last time was different. When checking the social media account for my ketosis supplement company, Perfect Keto, I noticed a rather ridiculous comment. To the best of my memory, the comment said something like this: “How dare you promote ketosis?! I HATE KETOSIS! My daughter is a diabetic and had to be brought to hospital the other day because she was in ketoacidosis! Shame on you and everyone like who you recommends a dangerous diet that kills people! You are killing people! AGHHH!” Not only is this comment wildly misinformed and ignorant, I think comments like this are more dangerous than the promoting the ketogenic diet. When people make comments like this, they use the same scare tactics and lack of facts that have recently overtaken our political system to influence people in not using very beneficial tools to their advantage. Sometimes you just have to use your brain. The unfortunate truth is that this lady isn’t the only delusional and misinformed one instilling fear into people who are trying to gain benefit from their nutritional choices. Plenty of mainstream doctors also think the ketogenic diet is life threatening. I’ve recommended the ketogenic diet to many of my patients trying to fix weight and metabolic issues they haven’t been able to correct for years. One of them mentioned this change to their primary care physician, who was reviewing the statins and several other medications they have this patient on, who reacted with disbelief. Ketosis! How could I recommend such a life threatening intervention?! They were told not to see such a quack like myself any more before Continue reading >>

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