Ketosis: A potentially dangerous side effect of the popular keto diet?

Ketosis bad breath

Last Updated December 20th, 2021

What is ketosis?

It is a metabolic state characterized by raised levels of ketone bodies in the body tissues.  This may be a consequence of diabetes or diet that is low in carbohydrates.  The word ketosis is derived from ketones, which are small fuel molecules in the body.  Ketones can be considered an alternative fuel for the body, which is produced from the fat we eat and are used when blood sugar (glucose) is in short supply.

Ketones are produced when we eat a few carbohydrates, which is the main source of blood sugar and moderate amounts of protein.  These circumstances lead to the fat getting converted in the liver to ketones, which then enter the bloodstream.  Ketones are then used by cells in the body in the absence of adequate glucose.

Ketosis insomniaKetones are also used by the brain in the absence of adequate carbohydrate intake, as the brain cannot function by burning fat and in fact, the brain requires a large number of carbohydrates for its normal functioning.  In the absence of carbohydrates, the brain gets its energy from the ketones instead.

People even feel more energized and focused when the brain gets to run on ketones, which are produced from fat and this, in turn, burns more and more fat, which can help you lose weight. Ketosis can be measured by testing urine, blood, or breath samples.

What happens during the state of ketosis?

Optimal ketosis can be attained by burning fat in a healthy way, which can lead to burning of harmful fat from different parts of our body. There are different types of fat namely subcutaneous fat, which is under the skin and the visceral fat, which accumulates around the organs and the abdomen.  The burning of visceral fats can lead to the reduction of harmful abdominal fat and have a healthy lifestyle.

The ketogenic diet can be helpful in reducing the levels of triglycerides. Triglycerides are fat molecules.  Consumption of low carbohydrate diet and also an overnight fast is helpful in reducing the triglycerides.  High levels of triglycerides are a strong heart disease risk factor.  Low carbohydrate diet can be helpful in increasing the levels of high-density lipoprotein (HDL), which is also called good cholesterol. It also helps regulate the triglycerides: HDL ratio, which predicts the heart disease risk.  Higher triglycerides: HDL ratio leads to higher heart disease risk.

A Keto diet leads to reduced blood sugar and insulin levels, which helps in treating type 2 diabetes. When we consume carbohydrates, they are broken down into simple sugars called glucose in the digestive tract, which enters the bloodstream and elevates blood sugar levels.  Since high blood sugars are toxic, the body responds with a hormone called insulin, which tells the cells to bring the glucose into the cells and to start burning or storing it.

Keto diet and insulin response

Ketosis bad breathThe quick insulin response tends to minimize the blood sugar spike in order to prevent it from harming healthy people, but many people, who are not healthy have major problems with this process, which leads to a condition called insulin resistance, which means that the cells do not see the insulin and therefore it is harder for the body to bring the blood sugar into the cells.

This can cause type 2 diabetes when the body fails to secrete enough insulin to lower the blood sugar after meals.  This disease is common in modern days affecting approximately 300 million people worldwide.  A simple solution to this problem is by cutting carbohydrates by which we remove the need for all of that insulin and in this way both blood sugars and insulin go way down.  According to research, consumption of low-carb diet can lead to a reduction of insulin dosage by 50%.

A balanced ketogenic diet helps in the treatment of hypertension, which is also called the main factor for heart disease risk. Low-carb diets are one of the most effective treatments for metabolic syndrome  It is a combination of symptoms, which include abdominal obesity, elevated blood sugar, elevated fasting blood sugar levels, high triglycerides, and low HDL levels.  All these symptoms improve considerably with the consumption of a low carbohydrate diet.

Consuming a low carbohydrate diet helps to lower the low-density lipoprotein (LDL) also referred to as bad cholesterol. People who have small particles of LDL have a high risk of heart disease, whereas people, who have large particles of LDL have a low risk.  Consumption of low-carb diets actually turn the LDL particles from small to large and in turn reduce the number of LDL particles in the bloodstream.

How is low carb diet beneficial for your brain

Ketosis manLow carbohydrate diets are therapeutic for several brain disorders. It should be noted that glucose is necessary for the brain to function and some part of the brain can only burn glucose.  If we do not eat any carbohydrates, a large part of the brain can also burn ketones.  This is the mechanism behind the ketogenic diet, which has been used to treat epilepsy in children who do not respond to drug treatment.  In many cases, a low carbohydrate diet can cure children with epilepsy.

According to one research, over half of the children on a ketogenic diet had a greater than 50% reduction in seizures, and 16% of the children became seizure free.  Low carbohydrate/ketogenic diets are being studied for other brain disorders as well, including Alzheimer disease, which is a progressive neurodegenerative disorder and Parkinson disease, which is a long-term degenerative disorder of the central nervous system that mainly affects the motor system.

Side effects and dangers of ketosis

Ketosis fatigueA ketogenic diet consists of eating a high amount of fat, a moderate amount of protein and few carbohydrates.  Fruits and vegetables are allowed only in limited amounts.  AHA recommends eating a variety of fruits, vegetables, whole grains, low-fat dairy, skinless poultry and non-fried fish, nuts and legumes, and limiting red meat, saturated fat, and sweets for a heart-healthy diet.  It is important to maintain a balance between a low carbohydrate diet and a low-fat diet.  It forces the body into a condition called ketosis, which means the body’s cells depend mainly on ketones for energy.

Ketosis seems to reduce the appetite and may affect hormones like insulin that regulate hunger.  Fats and proteins are helpful in promoting satiety and leading to lower calorie intake overall.

Low carbohydrate diets help lose weight but compared to other diet strategies, they are not more helpful.  Much of the weight loss in the initial stages of a ketogenic diet is water weight because carbohydrate stores in the body carry water molecules with them, so initially, the weight loss is exciting, but the weight loss inevitably slows down with time.

Below is a list of side effects from the ketogenic diet:

  • Acid reflux.
  • Hair loss.
  • Kidney stones.
  • Muscle cramps or weakness.
  • Low platelet count.
  • Impaired cognition.
  • Inability to concentrate.
  • Impaired mood.
  • Renal tubular acidosis.
  • Disordered mineral metabolism.
  • Stunted growth in children.
  • Increased risk for bone fractures.
  • Osteopenia and Osteoporosis.
  • Increased bruising.
  • Acute pancreatitis.
  • High cholesterol.
  • Insulin resistance.
  • Elevated cortisol.
  • Increased risk for cardiovascular disease.
  • Increased risk for atherosclerosis.
  • Arrhythmia.
  • Myocardial infarction.
  • Menstrual irregularities.
  • Amenorrhea (loss of period).
  • Increased risk for all-cause mortality.

Ketosis vs. Ketoacidosis

Ketosis loss of appetiteThere are also many misconceptions relating to ketosis and the most common one is mixing it up with ketoacidosis, which is a dangerous medical condition affects people with type 1 diabetes if they do not take insulin.  People tend to mix up these 2 conditions, which can be detrimental whereas both have distinct differences.

Ketosis is a 100% natural state, under full control by the body. It can be caused by a low-carb diet or by a brief period of fasting whereas Ketoacidosis is a severe malfunction of the body, with excessive and unregulated production of ketones.  This leads to symptoms like nausea, vomiting, and stomach pain followed by confusion and finally coma, which requires immediate medical treatment, as it can be fatal.

Ketosis: Remember this…

Having understood the benefits and potential side effects of ketosis with the facts provided above, it can be concluded that the ketogenic diet acts as a natural therapy for weight reduction in obese patients.  Ketosis significantly can decrease the level of triglycerides, total cholesterol, LDL cholesterol, and glucose, and significantly increase the level of HDL cholesterol in the patients.  Therefore, these results indicate that the administration of a ketogenic diet for a relatively long period of time is safe when monitored and supervised by a medical professional.

On the other hand, it can be misleading and detrimental when it is not monitored and supervised by a medical professional, which can lead to inappropriate levels of essential carbohydrates, protein, and fat, which are required for normal functioning of the body.


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