Keto acidosis or not?


Hi everyone.

Had a bit of a scare last night at a Boxing Day party and was wondering if anyone could shed some light on what is happening scientifically and whether I should be concerned or not.

Firstly, my background. I have a bmi of 20.4 and am not diabetic. I have been on a Keto diet for 4 months and am pretty comfortable on it and usually blow about 2.7mmols/ litre on my breath meter.

Before Keto I used to enjoy drinking wine and sometimes beer and didn’t have any problems doing so. Now I can’t really drink at all without feeling pretty ilI. but if I do it will usually be one glass of wine (any more makes me feel I’ll)
Last night I had 2 large glasses of wine accompanied by plenty of water, as it was a family party. I began to feel very sick and unwell. I thought I would check my ketones. I blew 7.9mmol/L. This frightened me as I believe this is Keto acidosis territory. But I am not diabetic.

So my question is. Is this ketone reading really that scary or is it the alcohol affecting the reading? Don’t want to destroy my liver and kidneys.

My ketones are back to 2.4 this morning but I did drink 2 litres of water after that reading.


Takes being WAY higher than that and also requires you to basically be an out of control insulin dependent diabetic to actually have ketoacidosis, Non Diabetic ketoacidosis is VERY rare since it would require multiple internal systems failing all at once for it to actually happen.

Also, you said you “blew” that number? Like breathe measurement? It was registering Alcohol at that point, not ketones. You can do the same thing with mouthwash.

(Take time to smell the bacon) #3

If you have a functioning pancreas, you will not get into diabetic ketoacidosis. As I understand it, doctors don’t start to worry until your serum β-hydroxybutyrate reaches 10 mmol/L, and symptoms don’t become noticeable until around 20. Diabetic ketoacidosis also involves hyperglycaemia, as well as hyperketonaemia.

There is also a condition called euglycaemic ketoacidosis, which is elevated ketones without elevated serum glucose. It happens only under certain circumstances, however, and your doctor would have warned you of the risk, if it were likely to affect you.

(Michael - When reality fails to meet expectations, the problem is not reality.) #4

First, if you’re using a breath measuring device - Ketonix, for example - the device measures acetone in parts per million. If the device you’re using claims to measure mmols, it’s not measuring mmols it is guestimating mmols from ppm. There is no direct correlation between ppm and mmol. Whatever algorithm the device uses, it may or may not be accurate for you. The only way ppm and mmols can be compared accurately - for you! - is by taking simultaneous acetone readings and blood readings with a blood meter.

Second, as noted by @lfod14, breathalyzers measure ethanol and related ‘…ols’ just as readily as acetone and can not distinguish between them. That’s why the instructions you got with the device say “Don’t drink before testing…” or something equivalent. So, your ‘high’ measurement was due to the ethanol you consumed.

Third, measuring ketones is an interesting thing to do for awhile. Many of us on this forum have tested ketones for varying periods of time only to stop doing so eventually because the readings vary so wildly that they eventually become useless for any meaningful purpose. They serve a purpose in a lab under controlled conditions, but not at home in the real world.

In your OP you say you’re not diabetic. You are are zero risk of acidosis. Best wishes.

(Greg Hollingsworth) #5

As I understand it - and I’m a Type 2 diabetic - if you are not taking some form of medication,i.e., insulin or other blood sugar lowering med, you are at no risk of ketoacidosis. Secondly, I use a blood ketone meter ( and find the results reliable.

(Take time to smell the bacon) #6

The medications that cause euglycaemic ketoacidosis are SGLT-2 inhibitors (anti-cholesterol drugs intended to replace the statins, since the last patent on a statin has now expired). And, as stated before, if the pancreas is producing any insulin at all, diabetic ketoacidosis is not a concern.


Thanks everyone for taking the time to answer my question. :grinning:. I can now confidently have a couple drinks at new year without panicking.