The Facts and Misconceptions About Ketosis and Ketoacidosis

The break down of body fat into fatty acids has as one of its side effects the formation of what is known as ketones. These acidic by-products of fat metabolism have the tendency of raising the body’s acidity level when they accumulate in the bloodstream and can degenerate into certain health conditions.

One way through which ketones can accumulate in the bloodstream is through the use of ketogenic diets. Ketogenic diets such as the popular Atkins Diet are of the view that carbohydrates are the major cause of weight gain and are therefore designed to limit the amount of carbohydrates consumed daily in their diets.

Carbohydrates are generally digested to produce glucose, which is considered to be the preferred energy source for the body as it is a faster burning energy. Although the body is capable of metabolizing muscle and liver glycogen (a mixture of glucose and water) as well as body fat deposits to produce energy, it prefers to get it from high glycemic index carbohydrates.

The initial phase of a ketogenic diet usually involves an acute deprivation of glucose designed to force the body to exhaust its own available glucose to a significantly reduced level that finally compels it to switch to burning its fat deposits for energy.

At this stage of a ketogenic diet, the rate of lipolysis (break down of body fat) increases drastically to push the body into a state known as ketosis in order to meet its energy demands. Ketosis is a state or condition in which the rate of formation of ketone bodies (by-products of the break down of fat into fatty acids) is faster than the rate at which they are being oxidized by body tissues.

Under normal conditions, ketone bodies are quickly oxidized to water and carbon dioxide but the increased accumulation during a state of ketosis makes their oxidation very difficult. However, the elevated accumulation of ketones in the bloodstream generally leads to increased body acidity forcing the body to attempt using it water reserves from its cells to flush out the accumulated ketones.

Ketogenic diets are therefore designed to achieve two very important weight loss goals which are: the reduction of insulin production due to the resultant low blood sugar levels; and also the state of ketosis which increases the rate of lipolysis (fat break down). The combination of these two factors makes the use of a ketogenic diet a very effective means of achieving rapid weight loss.

Unfortunately, there has been some mix up concerning the state of increased ketone accumulation in the body. This is partly due to the fact that a lot of people fail to realize that apart from the ketosis effect of ketogenic diets, one other physiological condition can equally cause increased ketone accumulation.

Besides ketosis, ketoacidosis is the other condition that can cause an increased ketone accumulation. While there is no doubt that both conditions lead to increased accumulation of ketones and therefore acidity of the body, the precipitating conditions are however very different.

Ketoacidosis (also known as Diabetic Ketoacidosis – DKA) is a serious condition whereby ketone bodies accumulate in the bloodstream of Type I Diabetic persons due to the inability of the body to produce sufficient amounts of insulin. This condition is worsened by an increase in counter-regulatory hormones.

Insulin deficiency in a diabetic person leads to hyperglycemia – an abnormal rise in blood sugar levels that can be as high as four times the normal amount of sugar in the bloodstream. In a normal individual, when there is an abnormal rise in blood sugar levels, more glucose is filtered by the glomeruli of the kidneys than can be reabsorbed by the kidney tubules, resulting in glucose excretion in the urine.

Hyperglycemia in and of itself is not that lethal but the side effects can be life threatening as it generally results in glycosuria (presence of glucose in the urine), increased urination, and dehydration. The loss of glucose in the urine generally leads to weakness, fatigue, weight loss, and increased appetite.

The continued excretion of glucose from the urine and the dehydration makes the body to become severely starved of energy. To bring the situation under control, the body may on the one hand continue excreting glucose in the urine causing a more serious condition, Hyperosmolar Hyperglycemia State (HHS) – which has a known mortality rate of about 15% in people with this condition.

On the other hand, the body may begin breaking down more triglycerides (stored body fat) as a way to produce more energy to control the situation. However, this increased lipolysis (release of fatty acids and ketones from fat cells, muscle tissues and the liver) causes an elevated accumulation of ketones (the by-products of fat break down) in the urine and bloodstream raising the acidity of the blood. The combination of hyperglycemia and acidosis (abnormal increase in blood acidity) is what is known as Diabetic Ketoacidosis – DKA.

Therefore, while there is actually an elevated amount of accumulated ketones in both conditions, there is however an increased blood sugar level in the state of ketoacidosis. Ketoacidosis can actually degenerate to hyperventilation causing subsequent impairment of central nervous system functions which can lead to coma and death.

It needs to be emphasized therefore, that dieters using ketogenic diets need to ensure that they drink a lot of water so as to reduce the increased acidity level of the body caused by the ketone accumulation. This also helps to flush out the accumulated ketones and to maintain a state of proper hydration.

In summary, while ketosis is caused by low blood sugar levels, ketoacidosis is however caused by increase blood sugar levels. Although ketone accumulation in the bloodstream and urine may be present in both conditions, their causes are however poles apart.



Source by Marcus J Michael