Understanding Good Ketosis vs. Bad Ketosis

Ketosis can be a scary word. You may have heard from a doctor or a friend that ketosis can be life-threatening. To understand the term, however, you need to know the difference between diabetic ketoacidosis (DKA) and nutritional ketosis, also called keto-adaptation.

A ketone is a chemical structure in which oxygen is double-bonded to carbon and pressed between two other carbons. Ketones are made from fat and some amino acids. Your body is able to produce three ketone bodies, called acetone, acetoacetone and beta-hydroxybutrate (B-OHB).

Your brain must have either glucose or ketones to function. Your body stores only approximately 24 hours worth of glucose. When glucose is unavailable, your liver is able to take fat and select amino acids (the building blocks of proteins) and convert them into ketones, which are then available to feed your brain. So ketones are necessary for your survival.

Diabetic ketoacidosis, on the other hand, occurs when type 1 diabetics, and sometimes insulin-dependent type 2 diabetics, do not get enough insulin and go into what is effectively a state of starvation. Without insulin, glucose cannot enter the cells. Because these people cannot produce any insulin, there is no feedback loop. The body just continues to produce more and more ketones. When the level of ketones reaches 15 to 25 mM, a profound metabolic inbalance occurs and the patient is critically ill.

This kind of metabolic derangement cannot occur in a person who produces even small amounts of insulin. When a person is “keto-adapted,” or experiencing nutritional ketosis, the beta-hydrobutyrate levels are between 0.5 and 3.0 mM, which are not harmful to your body.

When you significantly reduce your carbohydrate intake, your body stops relying on glycogen as its primary source of energy, and shifts to rely on fat. For most people, ketosis begins when you are taking in fewer than 50 grams of carbs every day. In ketosis, the body begins and continues to efficiently burn fat, inducing weight loss. It is important to understand the difference between these two ketone-related states, and to know that nutritional ketosis is a positive path to weight loss and improved health.