the Bridge Between Experience and Science

Ketosis Symptoms: the Bridge Between Experience and Science – Introduction

What is Ketosis

Ketosis is a state in which our blood contains an increased concentration of ketone bodies, namely acetone, acetoacetate, and beta-hydroxybutyrate.

Ketosis is a metabolic state characterized by elevated levels of ketone bodies in the body tissues, which can be induced by a ketogenic diet (nutritional ketosis) or fasting. While ketosis can be beneficial in the context of a controlled diet or fasting, uncontrolled ketosis in individuals with diabetes can lead to ketoacidosis, a potentially life-threatening condition.

For example, in people with diabetes mellitus or alcohol-related disorders, ketosis is a dangerous state, usually accompanied by other metabolic disarrangements that signal a failure from the body to properly adapt to a determined metabolic state. This usually occurs in the context of underlying infections or other health problems that destabilize the way the body deals with nutrients and energy.

On the contrary, nutritional ketosis is considered a physiological response to the diet, meaning a normal way to adapt to an environmental stimulus. While fasting and the early years of life may involve physiological ketosis, pregnancy is a condition where ketone levels might be carefully monitored, as excessive ketones can be concerning. Pregnant women should consult with healthcare providers before making significant dietary changes. In these scenarios, the concentration and ratio of ketone bodies are different from that of pathological causes of hyperketonemia. (1)

The Ketogenic Diet as a Way of Achieving Nutritional Ketosis

The ketogenic diet has been used since the 1920s to treat epilepsy, especially in children who do not respond to conventional seizure medications. Its application has been well-documented and continues to be a significant area of medical research and practice. At that time, antiseizure medications were not known, and many scientists found the high-fat, low-carbohydrate diet very useful for treating this life-diminishing disorder. (1)

Years have passed since then, and the ketogenic diet has continued to be explored for many other applications. Notably, the most studied one is its ability to improve weight in overweight people. Other applications under investigation include exercise performance, sleep, neurocognitive performance, cardiovascular health, diabetes management, and overall inflammatory control. (1-5)

Nowadays, the keto diet is probably one of the most popular dietetic approaches out there, with many people turning to this habit with the hope of improving their lives.

In this article, we are going to discuss the several symptoms that nutritional ketosis could produce in people and the relationship between these and the changes that the body experiences in nutritional ketosis.

Ketosis Symptoms in Nutritional Ketosis: What We Might Experience

Some Negative Ketosis Symptoms

It has been one or two days since one started this challenging dietetic regimen. Difficulties arise with frequencies and new food types since the classic Western diet is different from this new approach. Initially, a sense of lack of energy might arise, including decreased exercise tolerance. (6, 7)

The “keto flu” is a term used to describe a collection of symptoms including headache, fatigue, dizziness, nausea, and irritability that some people may experience when beginning a ketogenic diet. These symptoms are temporary and usually resolve within a week.

In other cases, people experience gastrointestinal issues, such as constipation, diarrhea, and abdominal bloating. Other less common manifestations include kidney stones, dehydration, and decreased bone density. Not every person experiences the same symptoms and with the same intensity or pattern, and not everyone has them. Fortunately, the adverse reactions of the ketogenic diet are transient and usually mild, lasting for a range of three to seven days. (1, 8)

Positive Ketosis Symptoms

Among the positive signs of doing keto, rapid weight loss is seen in the first few weeks, and most studies addressing this change found a significant weight loss in the first weeks in comparison to other dietetical approaches, whether or not the person is calory-restricted. The first quantity of weight loss is generally due to a greater water loss compared to a high carbohydrate diet. (1, 4)

An increase in urination can occur as the body sheds water weight and electrolytes during the initial stages of a ketogenic diet, necessitating increased fluid intake to prevent dehydration. This manifestation usually implies more intake of fluids.

A change in breath is commonly seen (9), which is fruity in odor and can represent discomfort to the person. This manifestation is characteristic of ketogenesis, the increased production of ketone bodies in the body.

With the days coming up, decreased appetite ensues, and people usually report a stable energy level and increased satiety with meals. (5)

At this time, there are several ways to test for the presence of hyperketonemia. The most accurate are blood tests, while urine and breath tests are less accurate but widely available to the general public. 

Why are Symptoms of Ketosis Produced

The Metabolic Switch

The keto diet produces a switch in the metabolic mechanisms that our bodies use to produce energy. Conventional diets usually consist of high amounts of carbohydrates (starch and sugars), which are transformed by the liver and muscle into glucose, a molecule that is easily transformed into energy.

When glucose is available, the whole body’s factory of energy is prepared to receive glucose to produce the energy for every other process going on. But when high fat and low carbohydrates are digested and processed, the cells do not receive the expected amount of glucose, and our liver starts producing it by way of its glycogen storages (a long chain of glucose molecules). As soon as glycogen runs out, hormonal signaling drives the usage of another substance as fuel: fat. (10)

The liver and muscles metabolize fat transported by the blood from our subcutaneous storages, producing energy from fatty acids at a lower cost process. As time under the diet goes on, the liver synthesizes a new molecule as a result of fat metabolism: ketone bodies. (11)

It Takes Some Days for the Body to Adapt

Progressively, almost the entire body is accustomed to using ketone bodies for energy production, with the exception of red blood cells and the proper liver cells, which rely on the energy produced by fats in the process of producing ketone bodies.

The metabolic switch takes some days to take over, and in the meantime, the body has to adapt to this new metabolic state. The symptoms of nutritional ketosis are mostly caused by the installment of this new mechanism at play. Imagine a factory that produces energy from the wind, but suddenly, they change to another natural source of energy, like a nearby river. The factory would have to change its machinery to process the new source of energy, and it would take some time.

In an analogous manner, the cells need to increase the machinery suitable for ketone body metabolism, and the system might struggle until the process is completed.

Ketosis Symptoms Frequently Asked Questions

Wrapping up

In conclusion, ketosis symptoms under physiologic nutritional-induced ketosis are a common manifestation of the body’s adaptation to a low-carbohydrate diet. It may take a few to several days for the symptoms to wane off, while the benefits of the keto diet progressively appear, manifesting as increased energy levels, weight loss, and improvement in sleep, cognition, and immunity. 

Ketosis symptoms are common and may differ from person to person, disappearing in a few days with minor repercussions. They probably pertain to the processes that underlie the metabolic shift until the body is completely adapted to the new diet.

A ketogenic diet, as well as any other health intervention, should be followed with the guidance of specialized health professionals in order to understand if the diet is the correct approach for you and to have the best results possible.

See Also

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Keto Diet for Beginners