Nutritional Ketosis versus Ketoacidosis

20-Aug 2022, by Lee Sandwith

One of the major risks reported on the internet about keto is ketoacidosis. But what is it, how does it differ from nutritional ketosis, and is it something that you should worry about?

What is ketoacidosis and how does it differ from nutritional ketosis?

As a reminder, ketosis is a metabolic state where the body starts to use ketone bodies for fuel instead of glucose.

The state of ketosis is primarily achieved through fasting or by keeping carbs very low in the diet.

This is what we call nutritional ketosis which is a completely safe, natural process.

Ketoacidosis, on the other hand, is a dangerous condition where the body produces dangerously high levels of ketone bodies.

It’s a super serious condition which can lead to coma or even death.

Ketoacidosis is mainly seen in people with Type 1 Diabetes (and more rarely in Type 2) and for that reason it’s often called Diabetic Ketoacidosis, or DKA for short.

The issue is where the body can’t produce enough insulin to use glucose.

DKA usually develops slowly and early symptoms include:

  • Thirst or a very dry mouth
  • Frequent urination
  • High blood glucose (blood sugar) levels
  • High levels of ketones in the urine

Other symptoms include:

  • Constantly feeling tired
  • Dry or flushed skin
  • Nausea, vomiting, or abdominal pain
  • Difficulty breathing
  • Fruity odor on breath
  • A hard time paying attention, or confusion

For the vast majority of people looking to start keto, ketoacidosis isn’t a risk worth worrying about as you’ll be naturally entering the state of nutritional ketosis.

Most people can monitor this by checking blood ketone levels. The best way to do this is by using a blood ketone meter such as the Keto Mojo.

  • Less than 0.5 mmol: negative ketone level
  • Between 0.5 and 1.5 mmol: low to moderate ketone level
  • Between 1.6 and 3.0 mmol: high ketone level
  • Greater than 3.0 mmol: very high ketone level

It’s even common for people to see readings over 3.0 mmol/L, especially when fasting but if you were experience ketoacidosis, your readings would be 3-5 times higher than these.

As a disclaimer, this content does not constitute medical advice. As a nutritionist, by law, my scope is limited to providing information and advice on anything related to nutrition.

For any medical conditions which you are experiencing, please consult with your physician.

To learn more about the basics of keto, please visit our YouTube channel. The best place to start is our Keto 101 series.

Need more help?

If you’re new to this stuff, or you’re struggling to succeed, you may benefit from a helping hand. We have lots of awesome health coaches in our community and you can book in for a free chat with me anytime.

About the Author

Lee Sandwith holds a Masters Degree in Clinical Nutrition and is a registered nutritionist with the Association for Nutrition. You can book a free 30 minute consultation with Lee here.

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