What is Ketosis? Are You In It?

Ketosis is a bodily process that takes place when the body lacks enough carbohydrates to burn for energy. Since the body lacks carbohydrates, it would rely on fats as energy. The burning of fats results in a substance called ketones. Am I in ketosis? Is ketosis a good or a bad thing? 

What is Ketosis? 

Cells use glucose as a source of energy. Glucose’s primary sources include starchy and sugary foods such as bread, pasta, rice, milk, yogurt, fruits, and dairy products. To use these as energy, the body breaks them down into simple sugars so that they can be used as energy. Some are stored in the liver and muscles as glycogen. If the body lacks glucose, it will make use of the stored fats as an energy source. The breakdown of fats triggers the release of the ketones; acids that build up in the blood and the body gets rid of it through urination. The release of the ketone is an indicator that your body is already breaking down fat. However, too many ketones in the blood can lead to poisoning or a state called ketoacidosis (2).

Facts about ketosis 

  • It is a normal metabolic process. A body that is deficient of glucose as a source of energy would use fat leading to the build-up of ketones in the body.
  • Following a low carbohydrate or ketogenic diet would encourage ketosis. A ketogenic diet helps you lose weight by using stored fats as an energy source.
  • Ketosis is common in people with diabetes but the prevalence is higher in people with type 1 diabetes than those with type 2.
  • Ketones produced in ketosis are a type of acid.
  • The release of the ketones triggers a condition called ketoacidosis; a fatal condition caused by an increased acidity of the blood (1).

Ketosis benefits 

  • It is beneficial to people suffering from diabetes, metabolic syndrome, and cardiovascular problems.
  • It can significantly improve the level of HDL (good cholesterol).
  •  It can significantly reduce seizure episodes in children and adults with epilepsy.
  • Further studies are made to find out the benefits of ketosis in people with acne, cancer, polycystic ovary disease, and Alzheimer’s disease (2).

Am I in ketosis? 

Some people purposely trigger their bodies to be in a ketosis state. They follow a ketogenic diet/keto diet to lose weight. It is a high-fat and low-calorie diet. Is ketosis bad or healthy? Well, there are advantages and disadvantages of triggering the body to be in a ketosis state. They are the following: 

Increased ketones 

You are in a state of ketosis if you have ketones in the blood, which can be detected in a blood sample. A breath and urine test kit can also be used to detect the level of ketones in the body. With a ketone testing kit, you can keep track of the ketone level right in the comfort of your home.

Evident weight loss 

Losing weight is one of the cardinal signs of ketosis. Your body burns fats instead of calories causing weight loss to be evident. Many people, especially those who follow a low carbohydrate and high-fat diet lose weight in ketosis. As a matter of fact, people lose more weight when following a keto diet as opposed to following a fad diet such as a low-fat diet. Weight loss can be easily noticed in the first few days, but true weight loss happens after a few weeks.

Increased thirst

An increased ketone in the body would cause you to feel thirsty than usual. The increased in thirst is a result of water loss. Keep in mind that if the level of ketones goes out of hand, it could lead to dehydration and electrolyte imbalance. If not managed right away could lead to fatal complications such as an increased risk in kidney stones. If you are following a keto diet, you have to make sure you drink plenty of water to prevent dehydration (4).

Cramps and muscle spasms

Since the body is in a state of dehydration, there is a tendency that you will experience an uncomfortable feeling such as muscle cramps and spasms. The muscle contracts as a result of electrolyte imbalance caused by dehydration. If you are following a ketogenic diet, make sure you supply your body with fluids and electrolytes.

Headaches

A person in a state of ketosis experiences headaches, which could last for a few days. If you purposely switch to a keto diet, you will notice that you constantly suffer from headaches. It is a common side effect of low carbohydrates and sugar in the body. Another culprit for the headache is dehydration and electrolyte imbalance. Although the headache is short-lived, some people experience it longer. For persistent headache, you need to see your doctor. Ironically, some people following a keto diet reported their migraines and cluster headaches have improved significantly.

Feeling tired and body malaise

In a state of ketosis, your body no longer has the same amount of carbohydrates, which causes you to feel weak and tired than usual. The feeling of weakness and fatigue is a result of the body’s switching from using carbohydrates as a fuel to using fat as an energy source. The feeling of weakness and fatigue is only temporary. As your body adjusts to the ketosis state, you will regain the level of energy you used to have. In fact, some even reported they feel more energetic than before (3).

Stomach Upset

Any types of dietary changes can have a direct impact on your stomach. If you switch to a keto diet causing your body to be in a state of ketosis, there is a tendency of experiencing stomach upset. Fortunately, you can prevent it from happening by drinking plenty of fluids and eating non-starchy foods. You should also increase your intake of fiber-rich foods to prevent constipation.

Halitosis (bad breath)

One of the definite signs that you are in a state of ketosis is bad breath or medically known as halitosis. Ketones leave the body through the urine and breath. The breath is kind of sweet or fruity in nature. The ones causing the unusual odor is acetone, benzophenone, and acetophenone. If the bad breath gets worse, you can at least make it less noticeable by brushing your teeth a few times a day or at least have a sugar-free gum with you.

Changes in sleep pattern

If the body is in a state of ketosis, various bodily functions will be affected including sleep patterns. Many people have a hard time sleeping soundly at night. Some may even experience nighttime walking. These symptoms are just normal and are short-lived. They will eventually go away after a few weeks (5).

The effects of ketosis in people with diabetes

Ketosis is a common phenomenon in people with diabetes. It is a result of not having enough insulin to process glucose in the body. Ketones in the urine is an indicator that diabetes goes out of hand. For people with diabetes mellitus type 2, a keto diet is recommended because the body still produces insulin but not properly used by the cells. If you focus on a keto diet, your carbohydrate intake is restricted, which is recommended in people with type 2 diabetes mellitus. Diabetic people should carefully monitor the level of ketone to prevent ketoacidosis, which can be extremely fatal (4). 

What is ketoacidosis and why it is fatal?

Am I in ketosis? If yes, then am I in danger of ketoacidosis? What really is ketoacidosis? Ketoacidosis pertains to a condition in which ketones in the blood goes out of control and slowly poisoning the body. It is a fatal condition that could quickly develop within a 24-hour period. Ketoacidosis is triggered by a medical condition that leads to a high level of ketones that work against insulin.

Ketoacidosis is most likely to occur in people with type 1 diabetes mellitus because the body no longer produces insulin. Type 2 diabetics may experience ketoacidosis but are less likely to happen. Below are the signs and symptoms of ketoacidosis: 

  • Dry skin
  • Abdominal pain
  • Dry mouth
  • Excessive thirst
  • Confusion
  • Difficulty concentrating
  •  Frequent urination
  • Fruity breath
  • Shortness of breath
  • Rapid breathing
  • Nausea and vomiting 

How to manage and prevent ketosis?

The level of ketones in the blood is strictly monitored. A urine testing kit is commonly used to check for ketone levels. Ketosis is less likely to take place in a healthy person, especially those following a well-balanced meal (6) . 

What triggers ketosis? 

  • Reducing the number of calories and carbohydrates.
  • Exercising for a long period of time.
  • Pregnancy

 What to keep in mind?

People with diabetes should carefully monitor the level of ketones in the body as too many ketones can lead to ketoacidosis. Diabetic ketoacidosis is an emergency situation as it could lead to coma and death. A person in a diabetic ketoacidosis state should be immediately brought to the hospital in an intensive care unit. The treatment and management approach includes the following: 

  1.     Replacement of body fluid to rehydrate the body and dilute excessive sugar.
  2.     Replacement of electrolytes to restore and maintain the functions of vital organs.
  3.     The patient is started on insulin therapy to reverse ketoacidosis. 

To prevent ketoacidosis, the following should be observed: 

  1. Make it a habit to monitor your blood sugar level. The ideal frequency of blood sugar monitoring is three to four times a day.
  2.     Make sure you discuss insulin dosage with your doctor.
  3.     Strictly adhere to the diabetes treatment plan.
  4.     Have a test kit with you to keep track of ketone levels.  

Ketosis vs Ketoacidosis 

Ketosis and ketoacidosis are a different thing. Although a lot of people often confuse them. Ketosis is a normal response of the body as it relies on fat for an energy source. On the other hand, ketoacidosis is a dangerous metabolic state, which can be extremely fatal when left unmanaged. A ketoacidosis state is caused by too many ketones in the blood making the blood acidic. Ketoacidosis is common in people with diabetes mellitus, especially in people with type 1 diabetes. Ketoacidosis may also happen in people who are severely alcoholic. 

Ketosis is a normal body response as it burns fats for energy consumption. A ketosis state is common in people following a low carbohydrate and high-fat diet –keto diet. Although it could lead to massive weight loss, there are a few side effects such as headaches, a feeling of fatigue, constipation, changes in sleep patterns, bad breath, and high cholesterol levels. These symptoms are only short-lived and will eventually go away after a few weeks. Although ketosis leads to weight loss, one should be cautious in following a keto diet. 

Final Words

If you are suffering from any medical conditions, it is best if you are going to consult your doctor before trying the diet. Nonetheless, a state of ketosis is generally safe for healthy people. Although, it does not suit everyone. A lot of people have benefitted from ketosis while others are a bit uncomfortable, especially if the temporary side effects kick in. 

You may want to lose weight by taking advantage of the ketosis effect following a keto diet, make sure you know all the pros and cons. A few discomforts may occur but are only temporary. It would be a struggle at first, especially if you are used to eating carbohydrate-rich foods but it will eventually pay off. The rule of thumb is to always ask the opinion of your doctor, especially if you are suffering from medical conditions like hypertension, diabetes mellitus, and metabolic conditions, to name a few.

References: 

(1) https://www.ncbi.nlm.nih.gov/books/NBK499830/

(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251269/

(3) https://www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/ketogenic-diet/

(4) https://www.physiology.org/doi/full/10.1152/ajpendo.00453.2013

(5) https://www.frontiersin.org/articles/10.3389/fpsyg.2015.00027/full

(6) https://www.ucsf.edu/news/2018/08/411526/keto-diet-gains-popularity-scientists-explain-what-we-do-and-dont-know

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