Can a ketogenic diet cause ketoacidosis? Can it put your life in danger or destroy your kidneys? - Aspire Natural Health

Can a ketogenic diet cause ketoacidosis? Can it put your life in danger or destroy your kidneys?

The ketogenic diet is popular these days.

The diet basically comes in two versions:

  • The hardcore ketogenic diet that has been successfully used to treat epilepsy for 80+ years, and more recently is proving helpful with a variety of cancers.
  • And a milder version that has become popular for treating diabetes, insulin resistance, and weight loss.

And for many people this milder version works great because they find that it blunts their appetite and eliminates cravings, making it easier to not overeat and lose weight.

But many people who are finding success with this way of eating are being told by well-meaning friends and doctors that this diet is DANGEROUS!!!! That it could kill them or destroy their kidneys, and they must stop it right away.

Is that true?

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First we have to understand what ketosis is…

 

Your body has two fuels it can run on, like a hybrid car. It can burn sugar and it can burn fat. And depending on what you’re eating and what you’re doing (sitting on the couch vs sprinting) your body is burning various mixes of both sugar and fat.

Besides the carbohydrates you’re eating, you have enough stored sugar in your body to last around 24 hours.

Fat is a different story, and most of us have enough fat on our bodies to last quite a long time.

There’s a famous case from 1965 of a 27 year old man who weighed 456 pounds. He fasted, taking in NOTHING but water, a multi-vitamin and some potassium pills, for 382 days. He not only survived, but did well, and lost 275.5 pounds.

After around 24 hours of not consuming carbs (either from not eating, or from eating a very low carbohydrate diet) your store of carbs runs out and your body switches over to primarily using fat.

The issue is that, while most of your body can switch over to using fat for it’s energy needs and be happy, there are a few parts of your body that can’t. These are your red blood cells that carry oxygen through your blood, some parts of your internal organs, and parts of your brain. Our bodies need a little bit of sugar and can’t run entirely on fat.

Now your body is able to make a small amount of blood sugar from the protein of your body (your muscles) or any protein you eat, but it’s not enough to supply all your cells with sugar.

Fortunately there’s a little “hack” your body uses, and that’s to turn some of your fat into ketones. Ketones are a special fuel made by your liver that aren’t fat and aren’t carbs, but act a bit like carbs. They’re able to replace some of the sugar needs of your brain and organs, reducing the amount of sugar your body needs to produce. This keeps you from breaking down all your muscles to make sugar, which is still a myth you’ll hear in some body-building circles or from some undereducated trainers.

So after 3-4 days of fasting or eating a very low carbohydrate diet, the body is running on three fuels. Most of your body is using fat, some of your body is using ketones, and a few cells are using the little bit of sugar coming from what your body can make or what might be coming from your diet.

This is completely natural, normal, and safe.

 

The trick to this safe state of ketosis is having a working pancreas. Even in the case of the 456 pound fasting man, who ate nothing at all for over a year, his working pancreas kept producing a trickle of insulin.

This tiny amount of insulin is necessary to keep the machinery working properly, and prevents the body from overproducing ketones.

You see ketones are mildly acidic. At normal levels your body compensates for this small amount of acidity produced by these ketones and they cause absolutely no problems.

However, in the case of a type 1 diabetic who’s pancreas has been destroyed by autoimmunity, they no longer produce any insulin, and unless they inject insulin there is no brake to stop the production of ketones.

And so the amount of ketones in the blood can rise to unnaturally high levels. This high level of ketones can begin to acidify the blood to levels that the body can’t adjust for. This is KETOACIDOSIS, and this acid blood can, as it continues to rise, begin to cause severe, and then life-threatening problems.

But it is not a ketogenic diet that causes this problem.

It is a lack of insulin.

As long as you have a functioning pancreas, and barring any extreme or freak circumstances, you will not be able to go into a state of ketoacidosis.

Ketoacidosis is dangerous and can hurt or kill you. And it will hurt your kidneys.

 

But, will a normal state of ketosis hurt your kidneys?

 

No.

The most common things that will hurt your kidneys are high blood pressure and high blood sugars, and the ketogenic diet has been shown to reduce both high blood pressure and high blood sugar. So for most people a well-formulated ketogenic diet not only won’t hurt their kidneys, but will actually protect them.

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Most doctors aren’t trained to understand ketosis, but are trained to be on the lookout for ketoacidosis. So when they hear the word ketones or ketosis, they automatically flash to this dangerous condition. In this case, they don’t know what they’re talking about. And the same goes for well-meaning friends or trainers.

A well-formulated ketogenic diet will not hurt you or your kidneys. You are not at risk of dying of ketoacidosis, and as long as you have a working pancreas, barring some extreme freak situation, there is no way you can even reach ketoacidosis, not even if you fasted for 382 days straight!

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Having said all this, a ketogenic diet is not right for everyone. While there are many ways to do a ketogenic diet incorrectly, some people just do not do well on this diet. This can be because of gut problems like dysbiosis, or hormonal issues, or other dysfunctions. Or it may just be a bad for a person’s genetics, or lifestyle.

Remember there is no one diet that works best for everyone.

 

Still for many people who are suffering with overweight, pre-diabetes, insulin resistance, and high blood pressure a mild ketogenic diet can work extremely well. And for people suffering with epilepsy, Alzheimer’s disease and various dementias, and certain kinds of cancer, a more aggressive ketogenic diet can work miracles.

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At Aspire Natural Health we are experts at helping people suffering with digestive issues and autoimmunity.

Are you looking for help?

Email us at info@aspirenaturalhealth.com or call us at 425-202-7849.

The first step of our process is to see if we’re a good fit for one another. If we are, we’ll talk about next steps. If not, that’s okay, and we’ll do our best to help you find the right person.
Everything is no-obligation and no-pressure, so you don’t have to worry. You have nothing to lose!

Call us at 425-202-7849 or email us info@aspirenaturalhealth.com now!

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Photo attribution – https://bit.ly/2Hd4TjR

Another Interesting post:

There is no such thing as THE Paleo diet

This Post Has 21 Comments

  1. Ashley says:

    This is a great article. Thank you! I do have 1 small question. Several times you mention “mild Ketosis”. What percent carbohydrates in a daily diet would you classify for mild Ketosis?
    Thanks so much!!

    • Tim Gerstmar says:

      Hi Ashley,
      Glad you enjoyed the article. The carb level for people to get into mild ketosis is going to vary across people depending on their body, their activity level, how sensitive they are to carbs, etc, etc. For almost everyone they must be below 100 grams of carbs per day. Many need to be below 75. Quite a few need to be below 50 grams. And some people definitely need to be down in the 20-30 gram range. People need to experiment and find what level works best for them. Hopefully you have a great practitioner on board who can help you.

      Is there anything else we can to help?

      Best,
      Dr. Tim Gerstmar

  2. Carleen says:

    Hi Tim,
    I found your article informative. I just wanted to add that I just read about a healthy (non-diabetic) breastfeeding mother who ended up with what was diagnosed as KETOACIDOSIS after just 10 days of doing a Low Carb High Fat diet (possibly as extreme as a Ketogenic diet) while she was still breastfeeding and the medics who treated her figured it must have been related to breastfeeding since she wasn’t showing any signs of having diabetes.

    I’m pregnant and have a recent diagnosis of gestational diabetes, which may in fact be pre-diabetes which went undetected (I’m almost 44 years old), and a Low Carb diet seems to makes sense to try and control it but I’m also concerned about how being pregnant might change the body in other ways to make a woman more susceptible to Ketoacidosis if I reduce carbs too much, just as breastfeeding seemed to have an effect on the young woman mentioned in that article.

    I hope more research is done in this area to help people work out how to safely use a low carb or ketogenic diet and know theirs bodies are able to use the ketones effectively. The final worrisome thing is that we are all guinea pigs when it comes to Keto diets in that long term effects of the diet are not well documented. Let’s see what happens over the next 10 – 20 years to those who try to maintain a Keto lifestyle.

    I wonder if intermittent fasting (just skipping breakfast or dinner every now and then) is a safer way to be in temporary ketosis with fewer of the possible risks of Keto dieting in the long term?

    (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4591635/ . Ketoacidosis associated with low-carbohydrate diet in a non-diabetic lactating woman: a case report)

    • Tim Gerstmar says:

      Hi Carleen,
      Thank you for the comment. That’s very interesting about the breastfeeding mom. We definitely want more research for sure in this area! Many people are experiencing benefits from a lower carb diet, and some from a keto diet. But you are right that we don’t know for sure what effects people will notice 10-20 years from now.

      Wishing you all the best with your pregnancy. Hope you and your child are happy and healthy!

      Best regards,
      Dr. Tim Gerstmar

  3. Anita says:

    Hi, I have followed a low carb diet on and off for 10 years. I’ve always been quite successful in losing weight while eating that way. I am type 2 diabetic and recently was hospitalized for DKA. Oddly though my blood sugar readings were low (between 60 & 85). The hospital was stumped and couldn’t figure out why I was DKA with low blood sugar. Could by ketogenic diet have caused this? Now that I’ve had DKA, should I stay away from a keto diet?
    Thanks
    Anita

    • Tim Gerstmar says:

      Hi Anita,
      I’m sorry, I have no idea. Without a thorough evaluation to truly understand what’s going on, I can’t say. If so, it’s very unusual as many, many T2DM have followed low carb, and even keto diets without DKA.

      If you’re considering getting some help and guidance, please reach out to us. We can chat to see if we’re the right fit for you. All you need to do is call 425-202-7849 or email us at info@aspirenaturalhealth.com. And we’ll talk more with you.

      Best,
      Dr. Tim Gerstmar

  4. Richard says:

    Hello, I’m a 29y old 5’7″ male (200lb) and I’ve recently started an extreme ketogenic diet, consuming >/=10g of carbohydrates a day (closer to carnivorous than keto), and absolutely no sugar. I’ve been healthy all of my life aside from acid reflux / GERD which I counteract with 40mg omeprazole. Any other ailments I’ve either ignored or haven’t discovered (no major pain or threatening situations which I felt needed attention). I was wondering how long it would take for DKA to take effect once I’ve reduced the carbs/sugar from my diet? I did quite a bit of research on the keto diet before delving into it, and the only negative aspect I can find is the Ketoacidosis warnings. The only information I can find is that the symptoms can be as sudden as 24 hours, but nothing I find states how long until the body will start the process leading up to it, am I still at risk, or have I been off of carbs/sugar long enough to where it would’ve happened long ago if it was a concern?

    Sorry for the long message, I’d like to continue my keto diet, but I have trepidation and anxiety issues. Hearing about DKA has me a bit worried, but I really don’t want to revert to my previous diet (carb and sugar heavy). Thanks in advance!

    Sincerely,
    Richard

    • Tim Gerstmar says:

      Hi Richard,
      DKA is virtually impossible for a healthy person on a low carb or ketogenic diet. Yes you can find examples, but they are extremely rare. If you’re doing well – feeling good with good energy and mood – than it sounds like you are doing fine. I strongly recommend having a good health practitioner to walk alongside you and help you make sure you’re on the right track, and to make sure there aren’t any issues. If you’d like to talk with us to see if we can help you, please give us a call at 425-202-7849 or email us at info@aspirenaturalhealth.com.

      Best,
      Dr. Tim Gerstmar

  5. Becky says:

    Anita, i was also recently hospitalized for euglycemic dka. Was on strict keto but was also taking Jardiance. Docs had hard time diagnosing due to normal blood sugars and i almost died. I am off the insulin now but struggling with high sugars even with meds. Was wondering the same thing.

  6. Richard says:

    Thanks for the reply Tim, I will reach out to you via email at some point in the future, I’m sure.

    For the sake of visibility though, another concern of mine is the fact that I have a snowball effect with my anxiety. Once I notice my blood pressure high or my heart rate spiking, I start to worry and it gets worse. I power through it and wait for it to subside (I do not take anti-anxiety meds, but I do have them). Numerous times I’ve checked my blood pressure at supermarkets where they offer it via the sit-down automated machine, as well as at home with a digital meter (once or twice), and each time my numbers were in the ~130/80’s range. However, whenever I visit my PCP it is somehow miraculously in the 120/70’s. I’ve told them about my multiple readings at 130/80 and they discount it every time, and do/say nothing about it.

    That being said, with my already high blood pressure and heart palpitations, will this diet be something I should avoid? The first week I’ve felt fine, as stated before, but I don’t think I’ve experienced the “adaptation” period… which includes “rapid heart rate” among other things. Coupled with my anxiety, this could be mentally disastrous for me.. but I deeply want to be healthy and rid of this sugar/carb addiction. Should I continue until 30 days have passed and see how I feel? Or should I wait and find a PCP who seems to care about what I tell them, and then continue? Thanks in advance, once again!

    Sincerely,
    Richard

    • Tim Gerstmar says:

      Hi Richard,
      Many people have found that a low carb (or ketogenic) diet helps drop their blood pressure. I’m always in favor of working with doctors that listen to what you have to say and take you seriously, so I’d recommend finding one you like who works with you. Blood pressure can flucuate a lot through the day and meters aren’t always very accurate. If it were me I would get my home blood pressure cuff and take it with me to the doctors office. Have them measure your blood pressure, and then use my cuff to measure my blood pressure and get a sense of how the two relate to each other. I’ve often seen the home cuff’s read a little higher than normal.

      I hope that helps!

      Best,
      Dr. Tim Gerstmar

  7. Shelly says:

    Richard,
    This is not my page and I am not a doctor. However, I have dealt with anxiety most of my life. Keto will work if you want to try it, but you will have to go into knowing the heartbeat issue will leave you not knowing if it’s an anxiety attack or not. My personal opinion is that weight training(very little cardio)was the best way to get healthier and it actually reduced the frequency of anxiety attacks quite a lot. If I had to guess, I’d say it upped my serotonin which helped but I really don’t know exactly why it lessened my anxiety. Whatever you choose, I wish you the very best with weight loss and your anxiety!
    Shelly

  8. Jonny Taylor says:

    Hi Tim,

    I started the Keto diet 7 days ago and already I am getting urinalysis readings of 8.0-16.0 which from my research seems too high. Would you recommend going to the doctor or would you consider these levels safe? Also are there methods of reducing ketone levels without coming out of ketosis?

    Many thanks,

    Jonny

    • Tim Gerstmar says:

      Hey Jonny,
      I’m not sure what the scale you’re using for urine ketones is. If you feel you’re a little too aggressively into ketosis, a small amount of carbs will lower your ketone production. Also make sure you are hydrating well, as many people lose a good deal of fluid as their insulin levels drop. If your energy and brain function are good, it is unlikely you need to go to the doctor.

      Hope that helps.

      Best,
      Dr. Tim Gerstmar

  9. Michelle says:

    I’m not a diabetic and have been following a ketotarian diet with occasional wild salmon for 10 days. I’m wearing a G6 continuous glucose monitor as an experiment. This morning the alarm went off because my glucose reading was 49. My glucose levels returned to normal levels after I had a low carb protein shake and some almonds. I have a ketone breath meter that says I have ketoacidosis but I feel totally fine. Should I be worried?

    Thank you!
    Michelle

    • Tim Gerstmar says:

      Hi Michelle,
      I can’t speak to your specific condition, but one thing that ketones allow the body to do is dip way lower in glucose than normal without any issues. There have been quite a few reports of people with blood sugar down into the 50s and below which normally makes people feel very bad, feeling completely normal if their ketones are up to help “replace” that blood sugar. When you say the breath meter is showing ketoacidosis, I’m not sure about that. The breath meters I’m aware of will simply tell you if you are in ketosis or not, not whether you are in ketoacidosis.

      I hope that helps. If you’d like some more professional guidance, just send an email to info@aspirenaturalhealth.com and we can arrange a time to chat and see if we’re the right fit to help you with whatever you’ve got going on.

      Best,
      Dr. Tim Gerstmar

  10. Ali Bradshaw says:

    Hello,
    My name is Ali, I started my keto journey in October of last year and lost 17 pounds in 11 days doing strict keto, 5% carbs, 20 protein and 75% fat. After reaching a satisfying goal I stopped and yet am now back on it, this time for more health reasons, a lot of people in my family develop diabetes do to bad eating and a bad lifestyle choice of no exercise and I wanted to beat the odds to say the least. Here I am one week into it again, 5lbs down. However my ketone levels are really high on the test strips say, 8.0-16. And I read where you could go into ketoacidosis. Ive googles and googled until I came across your article and found your email address, my main question is, how do I sat in ketosis and not reach ketoacidosis? Im 23, never had any known health problem ever and my glucose levels are always perfect when tested, yet with diabetes running so high in my family it worries me that my high level of ketones aren’t ok,…..

    Thanks,
    Ali

    • Tim Gerstmar says:

      Hi Ali,
      I can’t speak to your specific situation, but as a healthy person there is virtually no chance that you can go into ketoacidosis. High ketones on a urine strip are usually just a sign of the body adjusting to ketosis — the body isn’t used to burning all the ketones and the kidneys aren’t used to conserving them. If you feel well – good energy, good brain function – than it’s unlikely you have any issues.

      If you’d like a thorough workup to make sure everything is in good shape and you’ll get the most effectiveness from the diet, just send an email to info@aspirenaturalhealth.com with the subject line ‘Help with Ketosis’, and we can chat to see about helping you.

      Best,
      DrG

  11. Aseel says:

    Hi! So I’ve been doing keto for 3 weeks and I’ve stalled at 4kg weightloss. I haven’t lost anything for 2 weeks. Lately my back where my kidney is ( I only have one kidney) is feeling sore and I always feel out of breath. Do you think I should be concerned its ketoacidosis? If I have more carbs, will that help ease the pain on my kidney?

    • Tim Gerstmar says:

      Hi Aseel,
      Thanks for the message. I don’t know what’s going on for you, but to me it sounds like something about the diet isn’t working well for you, if your back feels sore and you’re out of breath. If I were you I would change your diet and see if things improve or you need to talk to your local doctor to see what’s going on.

      If you’re interested in a consultation where we can help you out, all you need to do is send a message to info@aspirenaturalhealth.com with the subject line CONSULTATION and we’ll be in touch to help.

      Best,
      Dr. Tim Gerstmar

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