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 >>
Results Weight loss Most people can lose weight if they restrict the number of calories consumed and increase physical activity levels. To lose 1 to 1.5 pounds (0.5 to 0.7 kilogram) a week, you need to reduce your daily calories by 500 to 750 calories. Low-carb diets, especially very low-carb diets, may lead to greater short-term weight loss than do low-fat diets. But most studies have found that at 12 or 24 months, the benefits of a low-carb diet are not very large. A 2015 review found that higher protein, low-carbohydrate diets may offer a slight advantage in terms of weight loss and loss of fat mass compared with a normal protein diet. Cutting calories and carbs may not be the only reason for the weight loss. Some studies show that you may shed some weight because the extra protein and fat keeps you feeling full longer, which helps you eat less. Other health benefits Low-carb diets may help prevent or improve serious health conditions, such as metabolic syndrome, diabetes, high blood pressure and cardiovascular disease. In fact, almost any diet that helps you shed excess weight can reduce or even reverse risk factors for cardiovascular disease and diabetes. Most weight-loss diets — not just low-carb diets — may improve blood cholesterol or blood sugar levels, at least temporarily. Low-carb diets may improve high-density lipoprotein (HDL) cholesterol and triglyceride values slightly more than do moderate-carb diets. That may be due not only to how many carbs you eat but also to the quality of your other food choices. Lean protein (fish, poultry, legumes), healthy fats (monounsaturated and polyunsaturated) and unprocessed carbs — such as whole grains, legumes, vegetables, fruits and low-fat dairy products — are generally healthier choices. A report from the Ame Continue reading >>
Ketosis: Symptoms, Signs & More
Every cell in your body needs energy to survive. Most of the time, you create energy from the sugar (glucose) in your bloodstream. Insulin helps regulate glucose levels in the blood and stimulate the absorption of glucose by the cells in your body. If you don’t have enough glucose or insufficient insulin to get the job done, your body will break down fat instead for energy. This supply of fat is an alternative energy source that keeps you from starvation. When you break down fat, you produce a compound called a ketone body. This process is called ketosis. Insulin is required by your cells in order to use the glucose in your blood, but ketones do not require insulin. The ketones that don’t get used for energy pass through your kidneys and out through your urine. Ketosis is most likely to occur in people who have diabetes, a condition in which the body produces little or no insulin. Ketosis and Ketoacidosis: What You Need To Know Ketosis simply means that your body is producing ketone bodies. You’re burning fat instead of glucose. Ketosis isn’t necessarily harmful to your health. If you don’t have diabetes and you maintain a healthy diet, it’s unlikely to be a problem. While ketosis itself isn’t particularly dangerous, it’s definitely something to keep an eye on, especially if you have diabetes. Ketosis can be a precursor to ketoacidosis, also known as diabetic ketoacidosis. Ketoacidosis is a condition in which you have both high glucose and high ketone levels. Having ketoacidosis results in your blood becoming too acidic. It’s more common for those with type 1 diabetes rather than type 2. Once symptoms of ketoacidosis begin, they can escalate very quickly. Symptoms include: breath that smells fruity or like nail polish or nail polish remover rapid breat Continue reading >>
Tweet Ketosis is a state the body may find itself in either as a result of raised blood glucose levels or as a part of low carb dieting. Low levels of ketosis is perfectly normal. However, high levels of ketosis in the short term can be serious and the long term effects of regular moderate ketosis are only partially known at the moment. What is ketosis? Ketosis is a state the body goes into if it needs to break down body fat for energy. The state is marked by raised levels of ketones in the blood which can be used by the body as fuel. Ketones which are not used for fuel are excreted out of the body via the kidneys and the urine. Is ketosis the same as ketoacidosis? There is often confusion as to the difference between ketosis and ketoacidosis. Ketosis is the state whereby the body is producing ketones. In ketosis, the level of ketones in the blood can be anything between normal to very high. Diabetic ketoacidosis, also known as DKA, only describes the state in which the level of ketones is either high or very high. In ketoacidosis, the amount of ketones in the blood is sufficient to turn the blood acidic, which is a dangerous medical state. When does ketosis occur? Ketosis will take place when the body needs energy and there is not sufficient glucose available for the body. This can typically happen when the body is lacking insulin and blood glucose levels become high. Other causes can be the result of being on a low carb diet. A low level of carbohydrate will lead to low levels of insulin, and therefore the body will produce ketones which do not rely on insulin to get into and fuel the body’s cells. A further cause of ketosis, less relevant to people with diabetes, is a result of excessive alcohol consumption. Is ketosis dangerous? The NHS describes ketosis as a pote Continue reading >>
Ketosis-prone Type 2 Diabetes
Background The original schema for classifying diabetes mellitus (DM) consisted of 2 categories known as type 1 diabetes mellitus and type 2 diabetes mellitus. Type 1 diabetes was also known as insulin-dependent diabetes. Patients with this type of diabetes were considered prone to develop diabetic ketoacidosis (DKA). Patients with type 1 diabetes were found to have an absolute insulin deficiency due to autoimmune destruction of pancreatic beta cells. Patients with type 2 diabetics, or noninsulin-dependent diabetes, were not considered to be at risk for DKA. Type 2 diabetes is strongly associated with obesity and a family history of diabetes. These patients have peripheral insulin resistance with initially normal or elevated circulating levels of endogenous insulin. Practice Essentials Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. See the image below. See Clinical Findings in Diabetes Mellitus, a Critical Images slideshow, to help identify various cutaneous, ophthalmologic, vascular, and neurologic manifestations of DM. Signs and symptoms Many patients with type 2 diabetes are asymptomatic. Clinical manifestations include the following: See Presentation for more detail. Diagnosis Diagnostic criteria by the American Diabetes Association (ADA) include the following  : Whether a hemoglobin A1c (HbA1c) level of 6.5% or higher should be a primary diagnostic criterion or an optional criterion remains a point of controversy. Indications for diabetes screening in asymptomatic adults includes the following [2, 3] : Overweight and 1 or more other risk factors for diabetes (eg, first-d Continue reading >>
Ketoacidosis Versus Ketosis
Some medical professionals confuse ketoacidosis, an extremely abnormal form of ketosis, with the normal benign ketosis associated with ketogenic diets and fasting states in the body. They will then tell you that ketosis is dangerous. Testing Laboratory Microbiology - Air Quality - Mold Asbestos - Environmental - Lead emsl.com Ketosis is NOT Ketoacidosis The difference between the two conditions is a matter of volume and flow rate*: Benign nutritional ketosis is a controlled, insulin regulated process which results in a mild release of fatty acids and ketone body production in response to either a fast from food, or a reduction in carbohydrate intake. Ketoacidosis is driven by a lack of insulin in the body. Without insulin, blood sugar rises to high levels and stored fat streams from fat cells. This excess amount of fat metabolism results in the production of abnormal quantities of ketones. The combination of high blood sugar and high ketone levels can upset the normal acid/base balance in the blood and become dangerous. In order to reach a state of ketoacidosis, insulin levels must be so low that the regulation of blood sugar and fatty acid flow is impaired. *See this reference paper. Here's a table of the actual numbers to show the differences in magnitude: Body Condition Quantity of Ketones Being Produced After a meal: 0.1 mmol/L Overnight Fast: 0.3 mmol/L Ketogenic Diet (Nutritional ketosis): 1-8 mmol/L >20 Days Fasting: 10 mmol/L Uncontrolled Diabetes (Ketoacidosis): >20 mmol/L Here's a more detailed explanation: Fact 1: Every human body maintains the blood and cellular fluids within a very narrow range between being too acidic (low pH) and too basic (high pH). If the blood pH gets out of the normal range, either too low or too high, big problems happen. Fact 2: The Continue reading >>
Overview Of Ketosis In Cattle
(Acetonemia, Ketonemia) By Thomas H. Herdt, DVM, MS, DACVN, DACVIM, Professor, Department of Large Animal Clinical Sciences and Diagnostic Center for Population and Animal Health, Michigan State University Ketosis is a common disease of adult cattle. It typically occurs in dairy cows in early lactation and is most consistently characterized by partial anorexia and depression. Rarely, it occurs in cattle in late gestation, at which time it resembles pregnancy toxemia of ewes (see Pregnancy Toxemia in Ewes and Does). In addition to inappetence, signs of nervous dysfunction, including pica, abnormal licking, incoordination and abnormal gait, bellowing, and aggression, are occasionally seen. The condition is worldwide in distribution but is most common where dairy cows are bred and managed for high production. Etiology and Pathogenesis: The pathogenesis of bovine ketosis is incompletely understood, but it requires the combination of intense adipose mobilization and a high glucose demand. Both of these conditions are present in early lactation, at which time negative energy balance leads to adipose mobilization, and milk synthesis creates a high glucose demand. Adipose mobilization is accompanied by high blood serum concentrations of nonesterified fatty acids (NEFAs). During periods of intense gluconeogenesis, a large portion of serum NEFAs is directed to ketone body synthesis in the liver. Thus, the clinicopathologic characterization of ketosis includes high serum concentrations of NEFAs and ketone bodies and low concentrations of glucose. In contrast to many other species, cattle with hyperketonemia do not have concurrent acidemia. The serum ketone bodies are acetone, acetoacetate, and β-hydroxybutyrate (BHB). There is speculation that the pathogenesis of ketosis cases oc Continue reading >>
When My Boyfriend Drinks Alcohol He Smells Like Oranges. Is There A Reason For This?
Thanks for the A2A. He may be experiencing ketosis. Ketosis occurs when your body does not have sufficient glucose to use as fuel, and starts to use alternatives such as proteins and fats instead. It's not necessarily harmful (low carb diets will induce ketosis) but it can be associated with conditions such as diabetes and over-active thyroid. He should discuss this with a doctor. More What Is Ketosis? Ketosis Continue reading >>
What Are Ketone Strips Used For?
This won't make sense unless you understand low-carb diets. Here's how a low-carb diet is supposed to work. A person eats about 30g of carbs per day for a couple days. That's not a lot of carbs. That's like two slices of bread. The body burns through all those carbs. Now that it can't burn carbs, it starts to burn fat. When you burn fat, you lose weight. When the body burns fat, ketones end up in the urine. Low-carb dieters use ketone test strips to test whether their bodies are burning fat. A positive sign of ketones can often predict future weight loss. If this sounds too good to be true, well it might be. The biggest problem with low-carb diets is that most people can't sustain them for long enough to cause permanent weight loss. Cravings for carbs can be surprisingly strong. Depending on the protein source, high cholesterol can be a problem too. Ketosis sounds bad but the symptoms are pretty mild - bad breath, nausea, fatigue. Nobody dies from ketosis. We all should be thinking about carbs to some extent. There's an awfully high sugar content in the typical modern diet. Diabetes is no fun. Even cavities aren't a picnic. Most people could cut some carbs and be healthier. Continue reading >>
Escaping The Fat Trap
Once you’ve been heavy for some time, your high insulin levels can make it hard to succeed in losing weight. Trying diet after diet and failing on each and every one is depressing. But when you discover the perfectly natural bodily process called lipolysis, hope can replace despair. To a person longing to lose weight, Nirvana is the definition of lipolysis: the process of dissolving fat. When you burn fat, it breaks down into glycerol and other fatty acids. How does the process actually work? Are there any drawbacks? There are plenty of laypersons and even physicians who think there must be. Burning off one’s fat sounds like a faddish trick. These folks give a skeptical shrug and say, "I’m sure people lose some weight with the Atkins approach, but don’t they gain it right back again?" The interesting thing is that if you adhere to the four phases the Atkins approach—which includes finding your Atkins Carbohydrate Equilibrium (ACE), meaning the amount of carbohydrates you can still consume and neither gain nor lose weight—you won’t regain the weight. The phase known as Lifetime Maintenance, though more indulgent, evolves naturally from the three weight-loss phases, thereby gradually teaching you a permanent way of eating that still moderates carbohydrate intake to the degree that is necessary for your individual metabolism. Many controlled carbohydrate regimens have been proposed over the years. They work with some degree of effectiveness for some people. However, many of them do not bring carbohydrate intake down to a level that will permit lipolysis. For people who suffer from metabolic obesity and have great difficulty losing, that is a grave weakness. Atkins, on the other hand, starts you off consuming 20 grams of carbohydrates. You then proceed at your Continue reading >>
What Are The Dangers Of The Ketosis Diet?
In the late 1990s and early 2000s, when the "Atkins" and low carb dieting thing was just coming on in a big way, there was a terrific number of idiotic claims made about the dangers of it -- many of them confusing (as the questioner points out) diabetic ketoacidosis, a serious condition, with voluntary nutritional ketosis, even though there is no relation whatever. But, leaving all that aside, some caution is in order. The diet seems to stress the adrenals. This has been noted anecdotally by many people who've followed the diet. It was also noted by Dr Wolfgang Lutz, one of the early pioneers of the diet, who personally practiced the diet for 40-odd years, as well as advocated the diet to thousands of his patients. He noted in his book on the subject ("Life Without Bread" was the title, though it was published later I believe under a different title) that some patients would suffer mild autoimmune reactions that required small doses of corticosteroids to control. This sounds like what would happen if the adrenals are failing to produce a normal amount of steroids. You can find a lot more of a mostly-anecdotal nature by searching for "ketogenic jaminet". Paul Jaminet is a popular health blogger who has written about what he perceives to be problems with the ketogenic diet, including the possibility of deficiency of mucus and other key glycoproteins. He has some scientific backing for what he is saying, but it is far from air-tight. Read and judge for yourself. You can also learn a lot from the comments below his posts. Jaminet and others have also written about the risk of kidney stones on the ketogenic diet, and this is a serious concern, albeit a rare occurence. As far as the kidney stress goes: this would I believe be easy to avert simply by taking some alkali during Continue reading >>
In Depth Look At Ketogenic Diets And Ketosis
What exactly is Ketosis? The metabolic state of ketosis simply means that the quantity of ketone bodies in the blood have reached higher-than-normal levels. When the body is in a ketogenic state, this means that lipid energy metabolism is intact. The body will start breaking down your own body fat to fuel the body's normal, everyday functions. What's So Great About Being In Ketosis? Establishing this metabolic state of ketosis even for a short period of time has many outstanding benefits. Benefit 1 The main benefit of ketosis is that it increases the body's ability to utilize fats for fuel, which gets very lazy on a high-carbohydrate diet. When on high-carbohydrate diets, the body can usually expect an energy source to keep entering the body. But in the state of ketosis, the body has to become efficient at mobilizing fats as energy. Benefit 2 Ketosis has a protein-sparing effect, assuming that you are consuming adequate quantities of protein and calories—0.7 grams per pound of body weight per day—in the first place. Once in ketosis, the body actually prefers ketones to glucose. Since the body has copious quantities of fat, this means there is no need to oxidize protein to generate glucose through gluconeogenesis. Benefit 3 Another benefit has to do with the low levels of insulin in the body, which causes greater lipolysis and free-glycerol release compared to a normal diet when insulin is around 80-120. Insulin has a lipolysis-blocking effect, which can inhibit the use of fatty acids as energy. Also, when insulin is brought to low levels, beneficial hormones are released in the body, such as growth hormone and other powerful growth factors. Benefit 4 Another small but very important benefit of the ketogenic diet is that when in the state of ketosis, ketones, alon Continue reading >>
Acetonaemia (ketosis) Of Dairy Cows
Note Number: AG0210 A very distinct problem for dairy cows is the disease of ketosis (or acetonaemia). The occurrence of this disease in dairy cows is related to an increased demand for glucose by the animal. Ketosis also occurs in other animals and the problem is known by various names, eg, pregnancy toxaemia in ewes. Most commonly, ketosis is seen either in high producing cows or cows on a poor diet. Signs of the disease can be seen before calving, but they occur most commonly in the first month after calving and occasionally in the second month. In a herd, ketosis can either be sporadic with only individuals affected, or endemic with many cows affected over a period. Cause The disease is an extension of a normal metabolic process that occurs in most heavily producing dairy cows. The basic problem in ketosis is a deficiency of glucose (or sugar) in the blood and body tissues. Glucose is produced by the cow from carbohydrates which are a major constituent of pastures and other supplementary feeds in varying degrees. In late pregnancy, glucose is directed from normal bodily functions to the nutrition of the developing calf. As lactation starts, glucose is essential for the formation of lactose (milk sugar) and milk fat. The requirement for glucose is at such high levels that the blood becomes low in glucose (hypoglycaemia). Fifty grams of glucose is required for each litre of milk with a 4.8% lactose test and 30 grams for each litre of milk with a 4% fat test. Cows (and other ruminants) cannot be fed glucose in their diet; it has to be made in the rumen from suitable carbohydrates in the diet. If the amount of suitable carbohydrate in the diet is not enough to meet the glucose needs of the cow in full milk, the liver starts to manufacture glucose from other basic compou Continue reading >>
Is The Keto Diet Effective?
Turns out Keto/ketosis can be very effective in a variety of applications. There is pretty awesome keto research happening right now, too. Seizures: Several thousand years ago, doctors weren't sure why fasting was such an effective treatment for children with seizures. Turns out, restricting carbohydrates and surviving on ketones is something the brain really likes. Obviously, fasting isn't an effective long-term solution, but nutritional ketosis (restricting net carbs to 20g-40g per day) is a great alternative, can be maintained indefinitely, and has helped children (and adults) control their seizures in cases where medicine couldn't. (90% achieved better management of their seizures, and about half of those were able to eliminate seizures entirely). Oxygen Toxicity: I was listening to a Tim Ferriss podcast with Dom D'Agostino (Dom D’Agostino on Fasting, Ketosis, and the End of Cancer ) and D'Agostino mentioned an experiment he conducted to test the limits of a body in ketosis when exposed to oxygen toxicity. Essentially, imagine a Navy SEAL team that has to remain underwater in a pond to evade detection. Their scuba gear cannot release bubbles, so they use a "rebreather" to recirculate the exhaled gas, but one of the risks in that situation is oxygen toxicity (see: Rebreather diving). The experiment involved inducing ketosis in rats, placed them in a pressurized environment to simulate the pressure of being underwater, and exposed them to 100% oxygen. Normally the rats would experience seizures after 15 minutes, however the keto-adapted rats were seizure-free for more than an hour! I suspect the mechanism that creates seizures in this situation is different from the mechanism that creates seizures in children, however the "treatment" of ketosis is identical and pret Continue reading >>
The Beginner's Guide To The Ketogenic Diet
Heard about the ketogenic diet but not quite sure where to start? What does it do to your body? How does it help? How does it not? What can you eat? Here are some questions we've answered for you in this simple guide to the ketogenic diet! 1. What Does A Ketogenic Diet Mean? The Ketogenic diet is a low carb, high-fat diet. It involves lowering carbohydrate intake drastically and replacing it with fat. This process pushes your body into a metabolic state called ketosis. 2. What Is Ketosis? Ketosis is a natural metabolic state in which the body burns fat for energy or fuel. Ketosis occurs when there is limited access to glucose, which is generally the body's preferred source of fuel. In this state, ketones become the main source of energy for the body and brain instead of glucose or blood sugar. 3. How Does The Body Go Into Ketosis? Ketosis most often occurs when one is on a very low-carb diet. To go into ketosis people usually need to consume less than 50gms of carbs a day. 4. What Can You Eat On A Ketogenic Diet? While on a ketogenic diet, one can consume - - All kinds of meat - Eggs - Nuts - Healthy Oils: Extra virgin olive oil, coconut oil - Butters - Cheeses - Preferably unprocessed feta, cheddar, goat or mozzarella cheese - Low-carb vegetables - Primarily green vegetables, tomatoes These are well within the range of foods that allow the body to go into ketosis. If you're vegetarian and looking to follow the ketogenic diet, you can replace the meat with cottage cheese. 5. What Foods Should You Absolutely Avoid? - Fruits (All kinds!) - Beans and Legumes - Kidney beans, chickpeas, lentils, etc. - Sugary foods - Candy, sodas, fruit juices, milkshakes, smoothies etc. - Unhealthy fats - Processed vegetable oils, sandwich spreads, etc. - Wheat based products - Rice, pasta, Continue reading >>