Ketosis: Symptoms, Benefits, Risks, and More

If you research different ways to lose weight, you’ll come across various diets and lifestyle tweaks to help your body burn fat more efficiently. Increasing the intensity and frequency of your exercise routine and adjusting the number of calories you consume daily are popular methods for reducing body fat. Another involves entering a metabolic state called ketosis, which is the mechanism behind many low-carb diets, including the ketogenic diet and the Atkins diet.

Before you attempt to achieve ketosis, you should know a few things about the process, including its potential benefits, risks, and how to approach it safely.

What Is Ketosis, and How Does It Affect Weight Loss?

The buildup of ketones, or ketone bodies, is known as ketosis.

Because ketosis shifts your metabolism and relies on fat for energy, your body can burn fat at a higher rate.

How Do You Achieve Ketosis Successfully?

Putting your body in ketosis can be challenging, to say nothing of staying in the state long-term.

Limiting Carb Intake

Limiting Protein Intake

Intermittent Fasting

This combination approach hasn’t been studied or proven to work for long-term weight loss, however, and the pool of research supporting it is very small. Each of these diets can be challenging to maintain alone, and combining them may make it even more difficult to stick to your plan.

Exogenous Ketones

Some people take supplements, such as exogenous ketones, to put their body in ketosis and help keep it there.

Exogenous ketones are also pricey, foul-tasting, can cause gastrointestinal symptoms due to their high mineral loads, and are awash in marketing that makes overambitious or scientifically unsupported claims about performance improvement, weight loss, and mental clarity.

How Do You Know You’re in Ketosis?

Checking your ketone level is one way to know if you’re in ketosis.

• Upset stomach
• Headache
• Fatigue
• Brain fog
• Irritability when hungry

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• Muscle cramps

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• Fruity-smelling breath
• Tiredness that gets better after a few days
• Constipation or diarrhea

The Relationship Between Ketosis and the Ketogenic Diet

Following a keto diet — a very low-carb, high-fat diet — focuses on replacing carbohydrates with healthy fats, while purposely forcing the body into ketosis for weight loss. Keep in mind that this diet doesn’t just focus on eating fewer carbs. It also focuses on eating more whole foods and fewer processed foods.

• 70 to 80 percent of your daily calories come from fat
• 10 to 20 percent come from protein
• 5 to 10 percent come from carbohydrates

Following a typical keto diet food list, you can eat certain foods freely, while you’ll need to limit or totally avoid other foods.

Foods to eat on the keto diet include:

• Meat, including beef, lamb, pork, poultry, fish, and seafood
• Eggs
• Dairy and unsweetened dairy alternatives, including full-fat cheese, plain, full-fat yogurt, cottage cheese, and unsweetened plant milks
• Healthy oils, such as olive oil, avocado oil, or coconut oil
• Avocados
• Low-carb, nonstarchy vegetables, like leafy greens, broccoli, and peppers
• Nuts and seeds
• Sometimes, berries

• Grains, such as rice and quinoa
• Foods made from grains, such as pasta, rice, bread, and pizza
• Foods high in added sugar, including sweets, many fizzy drinks, and cereals
• High-carb fruit, including apples, blueberries, cantaloupe, and strawberries

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Foods to restrict on the keto diet (but that you can still eat in small amounts) include:

• Dairy, which contains a sugar called lactose
• Fruit
• Starchy vegetables, including potatoes, butternut squash, beans, lentils, yams, parsnips, and pumpkins

Potential Keto Diet Benefits

• Weight Loss and Appetite Control Ketosis may help to reduce body fat in people who are overweight or have obesity, especially deep abdominal fat, while preserving muscle mass and reducing hormonal hunger signals and cravings.
• Better Blood Sugar and Diabetes Management The keto diet can lower blood sugar and insulin levels, improve HbA1c (which measures long-term glucose control), and reduce the need for medications in many people with diabetes.
• Gut Health Support Being in ketosis may increase the diversity of beneficial gut bacteria and improve the balance of healthy microbes in the digestive system. However, more data is necessary to confirm the potential long-term effects of the keto diet on the gut microbiome.
• Brain and Cellular Protection Ketone bodies can act as antioxidants that protect brain cells, enhance cellular energy production, and reduce inflammation throughout the body.
• Adjuvant Support in Cancer Therapy Keto dieting may help to starve cancer cells by cutting off their main glucose supply and making tumors more susceptible to treatments like chemotherapy and radiation. However, limited human data is available in this area, and more research is necessary.

Is Ketosis Safe and Healthy for Everyone?

Following a keto diet also means having to pass on grains, vegetables, and fruits, which can lead to micronutrient deficiencies, especially magnesium, selenium, phosphorus, vitamin C, and some B vitamins. And if you already have liver problems, placing extra load on the organ with an influx of fat to digest can worsen any liver condition you may have.

It’s also important to note that there have been no long-term studies on the effects of the keto diet, nor has there been research detailing what may happen to the body if it’s in a constant state of ketosis.

• Women who are pregnant or breastfeeding
• People on certain diabetes medications and insulin
• People with a low body mass index
• Children (unless prescribed by a doctor to manage certain types of epilepsy)
• People with gallstones
• People who have had their gallbladder removed
• Anyone with a history of disordered eating

No reliable studies have investigated the long-term effects of constant ketosis. But as a short-term weight loss approach, it appears to be generally safe for most otherwise healthy people.

What to Know About Ketosis and Diabetes

Although more research is needed, there is some evidence that following a ketogenic diet and achieving ketosis may be beneficial if you’re living with type 2 diabetes and need to manage your symptoms.

Because you can reach ketosis by restricting your carb intake, this diet may naturally lower your blood glucose levels. And if you’re overweight and living with diabetes, eating fewer carbs may help you lose excess pounds, which is another way to gain control of your blood glucose.

What Is the Difference Between Ketosis and Diabetic Ketoacidosis?

DKA can occur when ketone levels become too high, due to a lack of insulin, which means the cells can’t use glucose for energy. This puts the metabolism into a state of ketosis, and excess ketone production can cause a toxic reaction throughout the body.

Without treatment, this condition can lead to a diabetic coma or death.

Symptoms of DKA include extreme thirst and passing urine much more than usual. If you don’t get treatment, these symptoms may progress to the following:

• Rapid, deep breathing
• Dry mouth and skin
• Flushing of the face
• Fruity-smelling breath
• Headache
• Muscle aches or stiffness
• Extreme fatigue
• Nausea
• Vomiting
• Belly pain

If your blood ketone level is higher than 1.6 mmol/L, seek immediate emergency medical care.

How Can You Avoid Ketosis?

Some people intentionally achieve ketosis to lose weight by eating a low-carb, high-fat diet. If you don’t want to go into ketosis, eating a balanced diet that includes carbs, fat, and protein can prevent ketosis. Not skipping meals can also help.

• Carbs 45 to 65 percent
• Fat 20 to 35 percent
• Protein 10 to 35 percent