Is Dietary Ketosis Harmful To The Liver?
The mild dietary ketosis, such as that which is experienced during the Weight Loss phase of the Lean for Life program, is not harmful to individuals with a normal, healthy, functioning liver. Here is some information about ketosis that may help you to understand its role in weight loss: The carbohydrates you eat are converted to glucose, which is the body’s primary source of energy. Whenever your intake of carbohydrates is limited to a certain range, for a long enough period of time, you’ll reach a point where your body draws on its alternate energy system, fat stores, for fuel. This means your body burns fat and turns it into a source of fuel called ketones. (Ketones are produced whenever body fat is burned.) When you burn a larger amount of fat than is immediately needed for energy, the excess ketones are discarded in the urine. Being in ketosis means your body has burned a large amount of fat in response to the fact that it didn’t have sufficient glucose available for energy needs. Dietary ketosis is among the most misunderstood concepts in nutrition because it is often confused with ketoacidosis, which is a life-threatening condition most often associated with uncontrolled insulin-deficient 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. Dietary ketosis, however, 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 Continue reading >>
Should Endurance Athletes Go Keto? Ketosis And Ketogenic Diets For Endurance Athletes
When it comes to weight loss and endurance performance, dietary ketosis is the strategy everyone is asking about this year. On the surface, ketosis or a ketogenic diet offers everything an endurance athlete could dream of: endless energy, freedom from bonking, and an efficient pathway to weight loss. The diet has been all over mainstream magazines, it’s the subject of several new books, and the supplement companies have already jumped in with new products and a ton of marketing dollars. So, is it time for cyclists, triathletes, and runners to go Keto? First, a refresher course on what a ketogenic diet is. To achieve dietary or nutritional ketosis you need to severely restrict carbohydrate intake (fewer than 50 grams of CHO/day) so the body transitions to using ketones for fueling muscles and the brain. Ketones are produced from fat, which is why nutritional ketosis is so appealing to sedentary people as a weight loss solution. It’s appealing to athletes because we have a virtually unlimited reserve of fat calories to pull from but can only store 1600-2000 calories worth of carbohydrate in muscles, blood, and the liver. An athlete fueled by ketones would be theoretically “bonk-proof”, since bonking is the result of running low on blood glucose. [blog_promo promo_categories=”coaching” ids=”” /] Dietary ketosis for athletes is one of the most hotly contested subjects right now. Proponents point to the metabolic advantage of relying on fat instead of carbohydrate, and critics point out the physiological limitations of eliminating carbohydrate as a fuel for performance. You’ll find bias in both groups, either because scientists and coaches (including me) have been in the high-carbohydrate camp for many years, or because there’s a lot of money to be made b Continue reading >>
Are Ketones Dangerous?
Are ketones dangerous? The answer to that question is it depends. I think it’s important to note that ketones still may pose a risk for those of us on a ketogenic diet, pursuing nutritional ketosis. I have blogged a lot over the years about the benefits of a ketogenic (low carb, high fat) diet for type 1 diabetes. I even wrote an eBook about it. I began my dietary experimentation after 15 years of living with diabetes so my discussion of this topic often assumes that readers are also aware of their own limits and responsibility to establish their limits before inviting complex experimentation. As exciting as the results of a ketogenic diet are, risks must be understood in order to proceed safely. Ketones can indicate diabetic keto-acidosis or DKA, which is life-threatening insulin deficiency, for someone with type 1 diabetes. Sadly, far too many people with type 1 diabetes die from DKA every year. Although the risk is pretty low on an annual basis, there are large numbers of people who actually die from DKA. So, you can easily see why the medical system believes that ketones (or the condition it is associated with) can absolutely can be dangerous.We all enter into experimentation with ketosis having had the “ketones are dangerous” doctrine drilled into our heads from the time of diagnosis. When you have type 1 diabetes, assuming a standard carbohydrate driven diet, the appearance of ketones in any concentration suggests DKA (diabetic keto acidosis) which is life threatening! DKA occurs as a result of insulin deficiency and correlates with elevated blood glucose. In response, usually over a period of hours, the liver dumps ketones which accumulate in the bloodstream at levels approaching 20 mmol/l . At this level of concentration the blood acidifies and the symptom Continue reading >>
Ketone Supplements: More Harm Than Good?
Enjoy this article co-authored with my dear friend, Tatiana Schallert, who is co-serving with me, my ministry, and my family. I AM Love, Dr. Sharnael Have you noticed that Ketone supplements are so popular recently? I know my Facebook newsfeed is buzzing with different articles and brands promoting ketones. I honestly had no clue what the deal was so I decided to do some research, which is exactly what I encourage you to do before jumping on the bandwagon. There is a lot of information out there on this topic right now and from what I found – taking Exogenous Ketones may be more harmful than good. What are Ketones? Ketones are produced in the liver from fatty acids. Then they are consumed as alternative fuel by the body, particularly the brain, when blood sugar (glucose) is in short supply. The brain consumes lots of energy every day and it can’t run on fat directly – only in the form of glucose or ketones. Ketones are popularly known as “brain fuel.” Eating a no-carb, moderate-protein, and high-fat diet encourages the body to organically reach a state of Ketosis. It takes about 72 hours for the liver to be in full ketosis so the kidney can assimilate the changes as the ketones gradually increase. Then it takes about two weeks for your body to adjust to the new pathway. What Is Ketosis? When the body produces ketones it’s said to be in ketosis (you can test ketone levels through urine tests). The fastest way to get there is by fasting. However, fasting is not something we do forever. On the other hand, a low-carb or “keto” diet also leads to ketosis and is a more sustainable option. The idea of a ketogenic diet is to get the body to switch its fuel supply to run almost entirely on fat. As insulin levels become very low, fat burning increases dramatically 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 >>
Exogenous Ketones: To Ketone Or Not To Ketone
My thoughts on Exogenous Ketones After being contacted (following the Youtube Q&A) by several folks – both members of Ketogains and Internet strangers, I felt compelled to write as fair and even-handed a write-up on exogenous ketone supplementation as I feel can be mustered. I condition my response by saying this – I want to deal only in evidence and hypotheses grounded in biochemistry. I admit up front that this will probably become something of a treatise on what constitutes a well-formulated ketogenic diet. I don’t have the time (or the energy) to put together a document that covers all facets of the use of exogenous ketones in sufficient depth, so what I want to do is to address the folks that I see asking me about them most often – those who have excess body fat, and are looking to lose weight. They have been told about the potential benefits to fat loss via exogenous ketones, and they want to know if the hype is real. Those of you who know me (or read my previous post here) know that I like to respond with “it depends.” So…when the question is raised, “Should I supplement with exogenous ketones?” what do you think my answer will be? Probably not! (HA, I tricked you!)…but let’s explore why. As I’m sure this is going to be hotly debated enough (as the topic is raging in numerous ketogenic groups) there isn’t any value in dealing with speculation that doesn’t have a basis in science, nor in anecdotes. The challenge in dealing with exogenous ketone supplementation is two-fold: One side of the debate has a product to sell. Anytime someone’s livelihood is tied to your purchase of their product, bias and subjective interpretation of the evidence should be considered. The evidence (either for or against) their supplemental use by average schl Continue reading >>
Ketones in the urine, as detected by urine testing stix or a blood ketone testing meter, may indicate the beginning of diabetic ketoacidosis (DKA), a dangerous and often quickly fatal condition caused by low insulin levels combined with certain other systemic stresses. DKA can be fixed if caught quickly. Diabetics of all species therefore need to be checked for ketones with urine testing stix, available at any pharmacy, whenever insulin level may be too low, and any of the following signs or triggers are present: Ketone Monitoring Needed: Little or no insulin in last 12 hours High blood sugar over 16 mmol/L or 300 mg/dL (though with low insulin, lower as well...) Dehydration (skin doesn't jump back after pulling a bit gums are tacky or dry) Not eating for over 12 hours due to Inappetance or Fasting Vomiting Lethargy Infection or illness High stress levels Breath smells like acetone (nail-polish remover) or fruit. Note that the triggers and signs are somewhat interchangeable because ketoacidosis is, once begun, a set of vicious circles which will make itself worse. So dehydration, hyperglycemia, fasting, and presence of ketones are not only signs, they're also sometimes triggers. In a diabetic, any urinary ketones above trace, or any increase in urinary ketone level, or trace urinary ketones plus some of the symptoms above, are cause to call an emergency vet immediately, at any hour of the day. Possible False Urine Ketone Test Results Drugs and Supplements Valproic Acid (brand names) Depakene, Depakote, Divalproex Sodium Positive. Common use: Treatment of epilepsy. Cefixime/Suprax Positive with nitroprusside-based urine testing. Common use: Antibiotic. Levadopa Metabolites Positive with high concentrations. Tricyclic Ring Compounds Positive. Commo 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 >>
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 >>
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 >>
What Are The Optimal Ketone Levels For A Ketogenic Diet?
If you’ve just started a ketogenic diet, then you’ll know that it can be really tough to figure out if you’re doing keto right. Am I eating too many carbs? Too much protein? Should I still be feeling tired? When is the fat burning supposed to start? It’s confusing, and one of the most confusing aspects is what your optimal ketone levels are supposed to be. Unlike most other diets, the ketogenic diet is designed to put your body into a state of ketosis in order to get your body to start burning ketones instead of the glucose that it usually burns when you eat a high carb standard American diet (SAD). But to know whether you’re in ketosis and whether your body has enough ketones circulating for you to use as energy instead of glucose, you have to measure your actual ketone levels and then determine whether they’re high enough for you to be reaping the benefits of the ketogenic diet. If you’ve tried searching for this information already, then you’ll know that there’s some controversy depending on which expert you follow. So in this article, we’ll tell you exactly what the different experts are suggesting are the optimal ketone levels as well as give you recommendations for what ketone levels you should be aiming for depending on your goals with a ketogenic diet. A Few Quick Notes Before We Start… If you’re looking for signs other than testing your actual body ketone levels as to whether you’re in ketosis or not, then please check out this article instead that provides you with signs you’re in ketosis. If you’re a type 1 diabetic, then this article is not for you and the optimal ketone levels suggested below are not applicable to you. Please check out the tons of other ketone level articles on the web to ensure your ketone levels do not reach Continue reading >>
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Ketones: Clearing Up The Confusion
Ketones, ketosis, ketoacidosis, DKA…these are words that you’ve probably heard at one point or another, and you might be wondering what they mean and if you need to worry about them at all, especially if you have diabetes. This week, we’ll explore the mysterious world of ketones, including if and how they may affect you. Ketones — what are they? Ketones are a type of acid that the body can form if there’s not enough carbohydrate to be burned for energy (yes, you do need carbs for fuel). Without enough carb, the body turns to another energy source: fat. Ketones are made in the liver from fat breakdown. This is called ketogenesis. People who don’t have diabetes can form ketones. This might occur if a person does extreme exercise, has an eating disorder, is fasting (not eating), or is following a low-carbohydrate diet. This is called ketosis and it’s a normal response to starvation. In a person who has diabetes, ketones form for the same reason (not enough carb for energy), but this often occurs because there isn’t enough insulin available to help move carb (in the form of glucose) from the bloodstream to the cells to be used for energy. Again, the body scrambles to find an alternate fuel source in the form of fat. You might be thinking that it’s a good thing to burn fat for fuel. However, for someone who has diabetes, ketosis can quickly become dangerous if it occurs due to a continued lack of insulin (the presence of ketones along with “normal” blood sugar levels is not necessarily a cause for concern). In the absence of insulin (which can occur if someone doesn’t take their insulin or perhaps uses an insulin pump and the pump has a malfunction, for example), fat cells continue to release fat into the circulation; the liver then continues to churn Continue reading >>
Why Dka & Nutritional Ketosis Are Not The Same
There’s a very common misconception and general misunderstanding around ketones. Specifically, the misunderstandings lie in the areas of: ketones that are produced in low-carb diets of generally less than 50 grams of carbs per day, which is low enough to put a person in a state of “nutritional ketosis” ketones that are produced when a diabetic is in a state of “diabetic ketoacidosis” (DKA) and lastly, there are “starvation ketones” and “illness-induced ketones” The fact is they are very different. DKA is a dangerous state of ketosis that can easily land a diabetic in the hospital and is life-threatening. Meanwhile, “nutritional ketosis” is the result of a nutritional approach that both non-diabetics and diabetics can safely achieve through low-carb nutrition. Diabetic Ketoacidosis vs. Nutritional Ketosis Ryan Attar (soon to be Ryan Attar, ND) helps explain the science and actual human physiology behind these different types of ketone production. Ryan is currently studying to become a Doctor of Naturopathic Medicine in Connecticut and also pursuing a Masters Degree in Human Nutrition. He has interned under the supervision of the very well-known diabetes doc, Dr. Bernstein. Ryan explains: Diabetic Ketoacidosis: “Diabetic Ketoacidosis (DKA), is a very dangerous state where an individual with uncontrolled diabetes is effectively starving due to lack of insulin. Insulin brings glucose into our cells and without it the body switches to ketones. Our brain can function off either glucose or fat and ketones. Ketones are a breakdown of fat and amino acids that can travel through the blood to various tissues to be utilized for fuel.” “In normal individuals, or those with well controlled diabetes, insulin acts to cancel the feedback loop and slow and sto Continue reading >>
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 >>
When To Worry About Ketones
“Your blood sugar is over 250. We’ll have to test for ketones, just to make sure you’re not spilling any.” The nurse stuck a label featuring my name and date of birth onto a plastic cup. “The bathroom is down the hall and to the right,” she said. By now, I was familiar with the drill, having experienced it a handful of times in the past: Provide urine sample to endocrinologist and keep my fingers crossed that it’s negative. Fortunately, it was—no ketones spilled. Though we often toss the word ketones around when we talk about diabetes, there tends to be confusion about what ketones are and when they’re dangerous. What are ketones? Ketone bodies are produced by the liver and are byproducts of fat metabolism. They occur when muscles in the body (which normally uses glucose as fuel) begin to use fat instead. This can happen when a person restricts carbohydrates (i.e., following a ketogenic diet—see below), eats too little, or feels ill. Simply put, ketones are markers of fat burning in the body. People with diabetes need to be concerned about ketones, though, because they can be a sign of a life-threatening condition. The presence of ketones makes the blood acidic and can result in an illness known as diabetic ketoacidosis (DKA), which occurs when blood sugar levels are very high. DKA can be caused by not getting enough insulin, and it may occur prior to a diagnosis of type one diabetes. DKA symptoms of concern include a dry mouth, blood sugar levels greater than 240 mg/dL, strong thirst, and frequent urination. Without treatment, these symptoms can worsen into confusion, extreme fatigue, flushed skin, fruity-smelling breath, nausea, vomiting, stomach pain, and difficulty breathing. The most serious effects include swelling in the brain, loss of conscio Continue reading >>