Ketoacidosis

#22

??? I don’t know what you are trying to say here.

(Empress of the Unexpected) #23

I eat very little, but when I do eat, I eat a lot of meat. Had no idea what ketosis was before I joined the forum. Suddenly it was like. okay, that was that weird smell, ketosis. I’ve had it for years. I’m 61 years old and in great health. There is no way ketosis is harmful.

(Empress of the Unexpected) #24

I’m serious - when I was 30 I thought I had some weird allergy. But the strange thing is - when I monitor, my breath does not correlate with the blood monitor. Weird breath, low ketones. Go figure. Wasted ketones?

#25

Right, Ketosis is not harmful. Ketoacidosis, which is different, is, which was the concern. From what we can tell, Ketoacidosis is difficult to obtain for most without other factors.

(Empress of the Unexpected) #26

Yes, I am not diabetic So if I choose to eat less, its kinda a smelly situation.

(Michael - When reality fails to meet expectations, the problem is not reality.) #27

Blood ketones are available fuel. Breath ketones (acetone) are the exhaust gas from burning it, the fuel that got used. If you’re synthesizing more fuel than you’re burning, the liver eventually slows production. In the meantime the unused blood ketones both acetoacetate and beta-hydroxybutyrate eventually get dumped via the kidneys in urine. Generally, as we get fat adapted production and burn get in sync so less and less ketones gets dumped via urine. That’s why urine sticks aren’t useful after you’ve been fat adaptated long enough. The system becomes more efficient.

(Justin Jordan) #28

DKA in non type one diabetics isn’t THAT rare. It’s uncommon but it’s not incredibly rare. There’s also people that are ketosis prone type two diabetics (that’s the medical term, not mine) that are more vulnerable.

Beyond that, drugs like Invokana can cause euglycemic ketoacidosis, where your blood sugar is not particularly elevated because (apparently) the mechanism in them that causes you to excrete sugar in the urine prevents clearing ketones.

Which is how I ended up spending five days in the ICU in 2017.

And at that time, doctors didn’t not commonly know or advise that this was a possibility.

(melissa brunker) #29

Thx everyone, I found some links and sent them to her but unfortunately I think she is going to choose to ignore them. Makes me feel sad that her husband is dying (he is in his 40s) and she chooses to ignore the science and wants to stick with old protocols. Anyway as they say you can lead a horse to water but u cant make it drink. :frowning:

(Hyperbole- best thing in the universe!) #30

The researchers are far more to blame than your friend. It is perfectly reasonable to listen to your doctor over a friend about health issues. And reasonable for doctors to listen to the experts. Although at a certain point they should figure it out, especially now. The researchers on the other hand are inexcusable. I’m sorry your friend’s husband is paying the price for conventional wisdom.

(Karim Wassef) #32
(Bacon is a many-splendoured thing) #33

Nevertheless, elevated serum glucose is considered one of the diagnostics for diabetic ketoacidosis. I agree, however, that the hyperglycemia cannot be causative, as is borne out by the existence of cases of euglycemic ketoacidosis.

Apropos of someone else’s post, there is a lecture by Phinney available on YouTube in which he asks the audience for their highest ketone reading. One guy says something like 12.4 (as I recall), and Phinney doesn’t seem particularly surprised or perturbed by that reading. And obviously the guy survived the high reading without ill effect.

(Ellenor Bjornsdottir) #34

It’s time, in my humble opinion, to retire the word “ketoacidosis” (which has had its diagnostic threshold set lower and lower to the point of being etymologically inaccurate) for the current diagnostic criteria of “ketoacidosis” and move into the realm of calling it “hyperketonemia” instead. The threshold for diagnosing hyperketonemia should be set to the highest you’d expect your ketones to go during the longest fast you’d expect to do. So, this could be anywhere from 4.0 to 13.0 (higher risks acid-base derangement and thus true KA). It should also be lower when there’s higher blood glucose (I’d probably diagnose insulin deficiency when the sum of glucose+ketones (both in mmol; we could call this the GKMI - glucose/ketone magnitude index, not to be confused with the GKI/Bosworth index which is a ratio) is over 19 - it usually is in the runup to DKA) since higher blood glucose should elicit an insulin response, which should inhibit ketones.

Lactation ketoacidosis requiring hospitalisation, glucose and insulin is a thing that some people experience if they jump into a modified Atkins diet just after giving birth to a child or just after otherwise having lactation begin to occur. I have no idea why you’d become acid-base deranged from that, but I wonder if it’s that an excessive energy demand results in insulin going too low somehow?

(Bacon is a many-splendoured thing) #35

Usually that kind of ketoacidosis involves fasting, not just eating ketogenically while lactating. It might be that lactating mothers should simply not fast—though I have to admit that doesn’t seem evolutionarily sound.

Diabetic ketoacidosis is usually accompanied by hyperglycaemia, whereas lactational ketoacidosis is not. And nor is the euglycaemic ketoacidosis caused by certain drugs.