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Can your ketones be too high on keto diet?

Ketosis is when ketones are produced in the body from the breakdown of fat for energy. Only if too many ketones accumulate in the body may ketosis progress to diabetic ketoacidosis (DKA), a life threatening condition.

healthline.com - Ketosis vs. Ketoacidosis: What's the Difference? - Healthline

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Despite the similarity in name, ketosis and ketoacidosis are two different things. Ketosis is when ketones are produced in the body from the breakdown of fat for energy. Only if too many ketones accumulate in the body may ketosis progress to diabetic ketoacidosis (DKA), a life threatening condition. Ketosis is a natural metabolic process in which your blood develops a high concentration of ketones when the body converts fat into energy. On the other hand, DKA is a serious complication of type 1 diabetes mellitus. Learn about both conditions and the differences between them in this article. What is ketosis? Ketones are a chemical your body produces when it burns stored fat. When you’re fasting, for example, or if you are following a low carb diet, your body doesn’t have enough glucose to use for energy. Instead, it uses your stored fat as a fuel source and converts it into ketones. This is called ketosis. Many people choose a low carb diet to enter ketosis purposefully to support weight loss. Low carb diets like the ketogenic diet are common, but more research is needed to determine their safety and long-term sustainability. Talk with a healthcare professional before starting any extreme diet plan. Learn more about ketosis. What is ketoacidosis? While ketosis is a typical metabolic process, DKA is not. DKA is a diabetes complication in which the glucose and ketone blood levels get too high. The cause is an extreme lack of insulin. DKA also makes your blood too acidic, which can change how your internal organs like your liver and kidneys function. People with type 1 diabetes, which means their bodies do not produce insulin, are most often diagnosed with the DKA. More rarely, it may also occur in people with type 2 diabetes, which means their bodies either do not make enough insulin or make insulin that does not work properly. People with diabetes can get DKA for various reasons, such as becoming ill with a triggering virus such as COVID-19. Other reasons can include: not taking an adequate dose of insulin

experiencing a stroke or heart attack

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going through physical or emotional trauma DKA often develops slowly. However, if you’re vomiting, it may progress in just a few hours. It’s critical that you get prompt treatment. Learn more about diabetic ketoacidosis. How do ketosis and ketoacidosis feel? Ketosis may cause bad breath. Ketones are broken down for use as a fuel source, and acetone is one of the byproducts the body excretes in the urine and breath. This may smell fruity but not in a good way. On the other hand, the symptoms of ketoacidosis are: extreme thirst

frequent urination

dehydration

nausea

vomiting

stomach pain

tiredness

breath that smells fruity

shortness of breath

feelings of confusion DKA symptoms can also be the first sign that you have diabetes. How to tell the difference? You can take a simple urine test at home. For this test, you’ll place a dipstick into a clean catch of your urine. It will change colors based on the level of ketones in your urine. Urine Ketone Levels <20 mg/dL 30–40 mg/dL >80 mg/dl What do my ketone levels mean? Small Moderate Large Blood Ketone Levels <0.5 mmol/L 0.3–2 1–2 mmol/L 5–7 mmol/L 0.5–5 mmol/L 3–25 mmol/L What do my ketone levels mean? Normal After prolonged exercise After two days of fasting After three weeks of fasting After three weeks on ketogenic diet DKA (seek medical attention immediately) People living with diabetes who are seeking to lose weight will often have low to moderate ketones, which doesn’t increase the risk of diabetic ketoacidosis if blood sugar levels are well managed and within typical ranges. For people living with diabetes, blood ketone tests are an ideal method to check ketone levels because they measure beta-hydroxybutyric acid, a primary ketone involved in ketoacidosis. Treatment Ketosis does not require treatment. But if you develop ketoacidosis, you need to go to the emergency room. Ketoacidosis treatment usually involves: fluids by mouth or through a vein

replacement of electrolytes, such as chloride, sodium, or potassium

intravenous insulin

screening for other problems you may have, such as infection

Frequently asked questions The following are answers to commonly asked questions about ketosis and ketoacidosis. How common is ketoacidosis? Based on a 2017 sample of about 220,340 patients, the overall incidence rate of DKA is 61.6 cases per 10,000 hospital admissions. The incidence of admissions is higher in males than females and in children ages 1 to 17 years than in adults. The incidence and mortality rates are also higher among Black people than white people. In higher-income countries, the risk of death from DKA is less than 1% . According to research, deaths occur more often in older adults or those who have illnesses that trigger the condition. In children, the trigger is often a brain injury or cerebral edema. How do I know if I am in ketoacidosis? The Centers for Disease Control and Prevention (CDC) recommend that you check ketone levels if your blood sugar is higher than 240 milligrams per deciliter (mg/dL) . You can monitor blood sugar and ketones with over-the-counter test kits. You can monitor your blood sugar using a blood test strip and test for ketones using a urine test strip. Some blood glucose meters like Nova Max Plus and Abbott Precision Xtra also have the ability to check for blood ketones. When should I go to the emergency room? You should see your doctor or go to the emergency room immediately for evaluation and treatment if you have diabetes or if you take care of someone with diabetes and notice any DKA symptoms. Call 911 if the symptoms worsen quickly. Prompt DKA treatment can save you or your loved one’s life. Your doctor will perform a physical exam. They’ll also do a blood test to check your electrolytes, glucose, and acidity. The blood test results can help your doctor determine if you have DKA or other diabetes complications. Your doctor may also order: a urine analysis (urinalysis) to check for ketones

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