What is Ketosis? Top Signs, Symptoms and Ketoacidosis

What is Ketosis?

Ketosis simply is a metabolic state where the body has an elevated level of ketones. Typically, the body uses glucose/carbohydrates to produce energy. In the absence of carbohydrates, the body produces bodies called ketone. High level of ketones in the blood is called Ketosis. The body produces ketones from burning fats, which it uses as fuel.(1)

Ketosis is a term that is associated with people seeking to lose weight or those with diabetes. It is a specific diet plan that aims at inducing Ketosis to burn more fats. Its proponents say it improves the general health. People with diabetes usually experience Ketosis, especially if the body has less insulin or it is not using insulin in the right way.(2)

While Ketosis may be beneficial, some problems arise in extreme levels of Ketosis.

Ketosis fast facts

  • During Ketosis the liver releases ketone into the body by burning fats instead of carbohydrates. It occurs when there aren’t enough carbs in the body.
  • An increase in the level of ketones increases the acidity of the blood leading to a state called ketoacidosis – a condition that may be fatal.
  • Ketoacidosis may be common in people with type 1 diabetes, and it may lead to diabetic coma. So emergency medical treatment is essential.
  • Strictly following a ketogenic diet (low-carb) may cause weight loss by forcing the body to burn stored fats.

What is Ketoacidosis?

This is a condition in which the ketone level is abnormally high in the body. Such a state may poison the body. The condition can develop within 24 hours and can be extremely dangerous if not addressed.

Triggers of ketoacidosis include:

  • Illnesses that trigger production hormones that work against insulin at high levels.
  • Problems with insulin therapy – missing scheduled treatment or getting less insulin
  • Drug abuse
  • Physical trauma
  • Stress
  • Emotional trauma
  • Surgery

People with type 1 diabetes are at risk of this condition because they do not produce any insulin. Symptoms of ketoacidosis include abdominal pain, dry or flushed skin, nausea and vomiting, excessive thirst and dry mouth, difficulty concentrating, fruity breath, and frequent urination.

This condition can be treated by fluid replacement, electrolyte replacement, and insulin therapy, among others.

The Ketogenic Diet

Many people use Ketosis as a means of losing weight. The diet stresses on low carbs and using fats as the primary source of energy. The diet is not recommended for people having diabetes or those pregnant. Nevertheless, Ketosis usually sets in after three days of consuming less than 50 grams of carbs per day. The best keto diet plan can be three slices of bread, two small bananas, or a cup of low-fat fruit yogurt.


Ketogenic diet comes with importance, including:

  • Reducing seizures in epileptic children
  • Weight loss through burning fats
  • Helps maintain muscles
  • Lowers the risk of heart diseases

What are the Signs of Ketosis?

Following are the ketosis symptoms :

1. Muscle cramps and spasms

People on a ketogenic diet usually experience muscle spasms and pains due to dehydration and electrical imbalances.

Imbalances of electrolytes often disrupt electrical messages. So if you are on a ketogenic diet, ensure that you get enough electrolytes such as calcium, magnesium, potassium, and sodium from eating a balanced diet.

2. Bad/fruity breath

Bad breath is a common side effect, especially when people reach full Ketosis due to elevated levels of ketones. The exact cause of such small is acetone. It exits the body through breath and urine.(3)

You can solve this problem by brushing your mouth regularly or eating sugar-free gums. Alternatively, you can take sugar-free drinks.

3. Increased ketones in the blood

When you enter Ketosis, it means there are high levels of ketones in the blood.

You can determine the amount by using a specialized meter. The meter usually measures the number of ketones circulating in the blood by assessing the amount of beta-hydroxybutyrate (BHB) in your blood.

Experts say that nutritional Ketosis is defined as blood ketones ranging from 0.5–3.0 mmol/L.

4. Weight loss

A ketogenic diet is a means of losing weight. So when in Ketosis, it is expected that participants should lose some weight.

Weight loss may occur within a few days, i.e., water weight, but the fat loss may take several weeks.

Increased Ketones in the Breath or Urine

A Breath analyzer is an excellent tool to determine the amount of ketones in the body. This tool looks at the exact amount of acetones in your breathe.  Also, you can use the daily urine analysis technique that involves the use of special indicator strips. The strips also measure the ketone excretion through urine.

Other symptoms include appetite suppressions, increased focus and energy, thirst, headache, fatigue, and changes in sleep patterns.