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ImAScientistToo t1_ixuvcvz wrote

Keto or ketosis is the metabolic state your body is in when you are turning fat into ketones to fuel your body. Your body can handle this and clear all the waste products associated with it. Ketoacidosis is ketosis in overdrive to the point that your body can’t handle the waste products associated with it and is a medical emergency that requires medical intervention. It’s usually seen in uncontrolled diabetes. Acidosis has to do with your body’s natural pH level which usually rung from 7.35-7.45. Acidosis starts when your body’s pH is less than 7.35 and can be metabolic acidosis or respiratory acidosis depending on the cause. Metabolic acidosis is caused by the kidney not producing enough sodium bicarbonate (NaCHO3). It’s a metabolic process. I’m this case the lungs will compensate and blow off more CO2. When it brings your pH back to normal range it’s called compensated metabolic acidosis.

I’ll update this more in a little bit. I have a patient to go see.

Respiratory acidosis happens when the lungs don’t blow off enough CO2. This happens during respiratory failure and has many causes ranging from infection to chemical exposure. As CO2 builds up in the blood the ph lowers. The kidneys will compensate be making more sodium bicarbonate (NaCHO3). When the ph returns to a normal level we call it compensated respiratory acidosis.

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rabid_briefcase t1_ixvi002 wrote

There are 3 other replies, but I don't think any are really ELI5.

The answer needs a few parts:

> What exactly is keto?

Keto is short for ketosis, a change in how your body uses energy.

Your body uses building blocks for all kinds of things. Two of those building blocks are carbohydrates also called sugars, and hydrocarbons also called fats and oils. The body uses them for many purposes including using them to make energy. In chemistry the difference is fairly small, carbohydrates (sugars) contain Carbon, Hydrogen, and Oxygen, and hydrocarbons (fats/oils) contain Carbon and Hydrogen. The body is able to burn both of them for energy but it takes a slightly different chemical reaction.

Normally the body likes to use sugar (carbohydrates) found in food. If you don't eat enough carbohydrates, your body switches over to use fats and oils found in food. It takes several days of not eating carbohydrates before your body decides it needs to switch gears and get most of its energy from the fats and oils in food instead.

Normally when your body uses sugar it converts it into energy, water, and carbon dioxide.

When your body is in ketosis, the process of using fats and oils generates energy, water, and carbon dioxide, but the different chemical reaction also produces some acids called "ketones". That's where "keto" and "ketosis" get their names.

More on this in the third part.

> What is acidosis?

Acidosis is when there is too much acid in your blood.

There is an acid/base balance in your blood. Normally your blood has a pH of about 7.4. If your blood becomes too acidic it is called acidosis. If your blood becomes to basic it is called alkalosis. Acidosis is when your blood pH drops below about 7.35. Alkalosis is when your blood pH goes above 7.45.

Both acidosis and alkalosis are bad for your organs. If the blood is too acidic or too basic, your organs will start to fail and you will die.

> What is keto-acidosis?

It is acidosis (blood turning acidic) caused by ketosis (using fats and oils).

Burning fats and oils is a normal thing for your body, and it can usually handle it just fine. Normally your body can neutralize the acids and extract it into urine just fine. Sometimes, your body can't keep up. Diabetics are much more likely to both produce more ketones and also have more difficulty filtering them out.

If your body can't process the ketones out fast enough your blood becomes acidic.

When that happens, your body quickly shuts down. It depends on how acidic your blood becomes and how quickly it is shifting, but for many people ketoacidosis will kill in less than a day. The damage the acid does to your body can be reversed if caught quickly enough, but if doctors can't fix the acid-base balance in your blood quickly enough, you can get permanent damage in just a few hours, and then die.

> is it possible to unknowingly get into it..

Yes it is possible, but your body will feel really sick, really quickly. People feel super thirsty, start throwing up, have stomach pain, act confused, and smell weird like fruit. Usually people will recognize something is very wrong and will go to the hospital.

Since people with diabetes are more likely to experience it, it's good to learn the signs if you are around diabetics.

It is easily treated at the hospital if it is caught in time.

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tedead t1_ixuiw0n wrote

There is ketosis, and then there is ketoacidosis, aka DKA. Acidosis is bad and is caused by the body breaking down fats for a source of energy, which causes ketones to build up in your bloodstream when there isn't enough insulin in your body. Acidosis acidifys your blood.

After an 8 week hospital stay, in which I came out diabetic, I developed ketoacidosis within 20 hours, requiring another 2 day hospital stay. I felt hot, had unquenchable thirst, and generally felt as if I was dying.

DKA is a life-threatening condition that usually always requires a hospital stay.

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Educational-Eye5076 OP t1_ixujbfc wrote

So keto ain't a viable option unless untill you're prepared for severe outcomes??

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Flock_with_me t1_ixvdv6i wrote

Don't confuse diet-induced ketosis (which simply results from a very low-carbohydrate diet) with ketoacidosis, which is a serious medical condition. They are totally different things that involve some of the same mechanisms even though they sound similar.

For normal, healthy people, a ketogenic diet (one which induces ketosis) is not harmful. More specifically, it does not cause ketoacidosis.

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eviade t1_ixuk0fb wrote

Generally it's fine, diabetic ketoacidosis normally happens due to a lack of insulin. Insulin can reduce ketone concentration in the blood/prevent liver from producing too much. In a healthy person ketoacidosis isn't a huge concern (though it is possible)

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tedead t1_ixulasu wrote

In a healthy person, is it because their body naturally regulates the insulin levels in their body?

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eviade t1_ixun6ed wrote

Yes. I'm not educated in the matter but as far as I know insulin is necessary for energy to enter cells so without it carbs, ketones etc just float around in the blood doing harm where they go. This causes both a buildup of energy sources (like ketones that are acidic) in the blood as well as signalling the body that it is not getting energy. When this happens your body continues to break down fat to give you energy, which can't pass into cells without insulin, so it adds to the buildup. This vicious cycle continues until you finally get some insulin or the ketones become too acidic for your body.

I'm diabetic and I've gone high many times in my lifetime but never had ketoacidosis because I've not gone without insulin long enough for ketones to build up, the highs were caused by too much sugar not a lack of insulin. I've also been on a keto diet and had no problems.

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tedead t1_ixuo6y9 wrote

I am also diabetic, and I've been pondering over going keto to help with insulin sensitivity and to simply cut down on carbs. I've read that keto diets for 'betics can be a good thing. Did you feel better on keto? Did you notice benefits?

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eviade t1_ixuq4i2 wrote

The first time I tried I felt incredible (for a week), I also have insomnia and for that first week I felt energy I hadn't felt since my early teens. It was also quite freeing, I have a physical job and drive a lot for work and my bloodsugar was very stable even if the energy didn't last. The main drawback is you have to eat a lot to keep up calories, I ended up stopping after a year because I couldn't keep my weight up. Talk to your specialist team about it if you decide to try but so long as you can stomach eating tonnes of nuts and meat (though you need to be careful with the amount of nuts as one too many and you've got yourself the runs) it's worthwhile I think.

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tedead t1_ixuqose wrote

Many thanks for the additional information. I think I will talk to my endo about this when I see her next.

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eviade t1_ixuumbz wrote

No worries, I could say more but in the end my experience will probably be much different to yours as is the nature of our beast. Good luck!

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tedead t1_ixuk1cx wrote

No, keto diets are generally safe. I would need someone else to explain the ketosis part. I'm diabetic and even I have thought about doing a keto diet.

I assume this is what you're asking, right? Can I do a keto diet?

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Educational-Eye5076 OP t1_ixumk3k wrote

No actually I'm more into intermittent fasting.. I'm just concerned if my weight loss is due to ketosis or merely because i have been low on calories.. I actually want to adopt IF as a lifestyle. So far I'm doing great

But once i reach my goal weight ill have to nake necessary changes to maintain it. And that's what concerns me.

Ive read, once into ketosis if you again change your diet with primary intake of carbs, you'll move into ketoacidosis.

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tedead t1_ixuk70h wrote

These are two different conditions, DKA is something T1 and some T2 diabetics can get.

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rebel1031 t1_ixvf8p9 wrote

Keto for a diet can lead to ketosis which is just your body burning fat instead of carbs (assuming you’re not eating many carbs with your keto diet). It’s not the same as keto acidosis.

Unless you have some underlying problem, one doesn’t lead to the other.

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CreateANewAccount654 t1_ixulyjc wrote

There's Diabetic KetoAcidosis, which can be fatal. Then there's what the no-carb-diet folks call 'ketosis', when theyve carb-fasted long enough to burn some kinds of fat.

If you still have questions, please ask your doctor. Rando's on Reddit cannot advise you on what is safe.

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