Ketosis is a process that occurs in the body when someone restricts their carbohydrate intake and the body must turn to fat for energy. As the body burns fat it produces ketones, which can be used to fuel activity.
Most people encounter the concept of ketosis and/or experience ketosis in relation to low-carbohydrate dieting. Low-carb dieting is effective for weight loss and can be especially beneficial for people with diabetes.
You achieve ketosis by limiting the number of carbohydrates consumed.
For most people, ketosis occurs after approximately three to four days of consuming fewer than 50 grams of carbohydrates per day.
Two of the most popular low-carb diets – the Atkins diet and the keto diet – restrict carb intake to no more than 20 grams a day temporarily or permanently. To make up for the deficit, dieters must consume high amounts of other macronutrients, including fat and protein.
There are pills or supplements in powder or oil form that claim to raise your ketone levels. The jury is still out on whether they are effective or even safe. It’s important to speak to your doctor before using this or any other dietary supplement.
In addition to weight loss, ketosis provides many additional health benefits. Initially, the keto diet was recommended for seizure-prone children. Some adults with epilepsy also eat a modified Atkins diet.
Keto dieting is also recommended for some people with type 2 diabetes, metabolic syndrome, and insulin resistance. There are also studies underway concerning ketosis’s effect on cancer, polycystic ovarian syndrome (PCOS), and nervous system disorders including ALS, Alzheimer’s, and Parkinson’s.
Low-carb dieting is considered safe for most people. It’s still important to discuss dietary changes with your doctor, but a reduction in carbs improves the diets of most Americans.
However, despite the benefits, ketosis does produce some unpleasant side effects. This is particularly true in the early stages when your body is adjusting to this condition. Negative side effects are most common during the first week of ketosis.
The most common negative side effects of ketosis include:
Most people find that increasing water consumption during the early stages of ketosis eases or prevents many of the symptoms.
It’s also important to note that kidney stones are a common risk among people eating a very low-carb diet. Kidney stones are especially risky for young children in ketosis. Doctors recommend potassium citrate supplements to reduce the risk of kidney stones.
The primary difference between ketosis and ketoacidosis is that ketosis is generally considered positive and ketoacidosis is a medical problem. However, the two are closely related.
Healthy people who eat a proper diet rarely have problems burning fat without their body making ketones.
If they reduce their carbohydrate or caloric intake, it might trigger their body to switch to ketosis. This means the body turns to fat stores for energy when it doesn’t get what it needs from glucose consumption.
Ketosis can also occur during pregnancy or after exercising.
People who have uncontrolled diabetes might be in danger if their body switches to ketosis. If ketones build up because the diabetic body cannot process and eliminate them properly, it can lead to dehydration and a chemical imbalance. Eventually, the blood becomes acidic – ketoacidosis – which can cause coma and/or death.
Ketoacidosis or diabetic ketoacidosis occurs when a diabetic person does not make enough insulin. It might also occur if they are dehydrated or they are sick or injured.
Although not as common, non-diabetic people can develop ketoacidosis. It’s most common among alcoholics and people with overactive thyroids. It’s also a side effect of starvation.
Symptoms of ketoacidosis include:
Vomiting is especially risky for diabetics. It speeds up the process of diabetic ketoacidosis. Within just a few hours someone can experience a coma. If you or a loved one is diabetic and experiencing vomiting for more than two hours, seek medical attention.
One of the best ways to monitor ketones for dieting or to ensure you aren’t experiencing diabetic ketoacidosis is to perform ketone testing. Testing allows you to determine the level of ketones in your blood or urine.
Ketone testing is done with test strips that are inserted into your urine stream. The test strips change color indicating the level of ketones in your urine.
There are also blood sugar meters that measure blood ketones.
Your doctor can help you if you aren’t sure about testing or don’t know how to interpret your test results.
Determining whether or not ketosis can help you improve your health can be a challenging process for most people. The best thing you can do is discuss your current health, and your weight loss, and overall health goals with your doctor.
Mayo Clinic. “Diabetic Ketoacidosis - Symptoms and Causes.” Mayo Clinic, 2018, www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/symptoms-causes/syc-20371551.
Harvard T.H. Chan. “Diet Review: Ketogenic Diet for Weight Loss.” The Nutrition Source, 7 May 2018, www.hsph.harvard.edu/nutritionsource/healthy-weight/diet-reviews/ketogenic-diet/.
“Is the Keto Diet Safe? USC Experts Have Some Serious Concerns.” USC News, 19 Feb. 2019, news.usc.edu/154342/is-the-keto-diet-safe-usc-experts-have-some-serious-concerns/.