Is Ketosis dangerous? Haven’t people died while following ketogenic diets?
Without fail, every single person who considers a ketogenic diet plan wants to know the answers to these questions.
And rightly so, after all, no one wants to die or cause themselves permanent damage from trying to lose a few pounds. It doesn’t matter how ripped you are if you’re dead!
As regular readers know, I’m a big advocate of ketogenic dieting for fat loss mainly because of its ability to reduce hunger which in turn naturally lowers caloric intake and results in easy fat loss.
Unfortunately, the mainstream doesn’t like ketogenic dieting and ever since Atkins there’s been attempts to discredit this way of eating.
One of the most common criticisms of ketogenic diets is that ketosis is a metabolically dangerous state to be in and that it can be toxic. In this article I’ll clear up this myth and explain why you have nothing to worry about.
Is Ketosis Dangerous?
The simple answer is no.
Ketosis is not dangerous, it’s ketoacidosis that is dangerous but you’ve nothing to worry about. The confusion between the two is usually the reason people make false statements about the dangers of keto.
Unfortunately even people you’d expect to know better get this wrong…personal trainers, doctors and nutritionists to name but a few.
Maybe they stop researching and reading once they get a few letters after their name and feel like they’ve made it. I don’t know but what I do know is that they’re helping to spread misleading information even if they don’t know it.
The confusion usually stems from them not understanding the difference between ketosis and ketoacidosis
For the general public to be confused between the two similar sounding terms is understandable, but from the very people we look to for accurate advice it’s simply not good enough!
All the public need to hear is one person who should know what they’re talking about state that ketosis is dangerous and that’s it. The question “Is ketosis dangerous?” has been answered (albeit incorrectly) and it’s validated their belief it’s dangerous and they move on.
Unfortunately, they’re missing out on one of the best ways to lose fat without the burdens of hunger and having to always count calories.
Is Ketosis Dangerous?: Ketosis and Ketoacidosis
Let’s take a quick look at the differences between ketosis and ketoacidosis and clear this myth up once and for all.
Ketosis is the metabolic state your body goes into when glucose is not available (due to carbohydrate restriction).
When glucose is not available it forces the body to begin burning alternative fuels for energy. The alternative fuels that can be burned are:
- Amino acids (your muscles)
- Ketones (produced by your liver)
- Free fatty acids (dietary fat and body fat)
When you follow a ketogenic diet we want the body to burn fat. The way to ensure this happens is to consume adequate protein and engage in resistance training.
This forces the body to spare your muscle mass and use a combination of ketones and fat for fuel.
Ketoacidosis refers to the potentially fatal metabolic state which happens when the body produces too many ketones.This is where people get mixed up.
They assume that because they’re in ketosis and the body is burning fat and ketones for fuel that it’s possible for the body to produce too many ketones which can be fatal.
This simply isn’t true.
Only diabetics or alcoholics (1) are at risk of ketoacidosis, as long as you don’t suffer with these illnesses you are physically unable to produce too many ketones.
Let me say that again to reinforce the message:
Non Diabetics and Non Alcoholics WILL NOT Produce Too Many Ketones!
To illustrate this, let’s take a look at how many ketones the body produces during ketosis and during other situations. This will make it easier for you to understand the answer to the question “is ketosis dangerous?”.
The standard method of measuring the amount of glucose in the blood is to use the mmol/dl metric, the higher the mmol/dl number the more ketones you are producing:
Concentration of Ketones (mmol/dl)
Up to 2
Up to 25
*for source see references at footer (2)
That makes a total of 8 mmol/dl! Surely that’s ketoacidosis and its dangerous right?
For everyone other than diabetics and alcoholics the body has a series of feedback loops which prevent ketone concentration ever getting too high.(3)
Let me explain how it works to ease your mind, presumably alcoholics wouldn’t be reading a diet book so we’ll focus on diabetics instead.
Why Diabetics Produce Too Many Ketones & Why You Won’t!
So now you know the answer to the question “is ketosis dangerous?” you may be wondering why it’s only diabetics and alcoholics who are at risk.
So just why is ketosis dangerous for this specific group of people? Let’s take a look at the unique challenges diabetics face and in doing so it’ll help illustrate why you’re safe.
Type 1 diabetics are unable to produce insulin naturally which is why they take insulin injections in order to maintain stable blood glucose levels.
If a diabetic doesn’t receive insulin for a period of time they enter a type of ketosis. Unlike the dietary ketosis where you can burn the fat and ketones for fuel, a type 1 diabetic is unable to burn the ketones as a fuel.
This is thought to be because there is enough glucose available which means their bodies preferentially burn that for fuel instead.
The problem is made worse by the fact type 1 diabetics produce almost four times as many ketones as a non-diabetic. As they can’t burn these off for fuel (because the body isn’t fat adapted) they have a high concentration of ketones they can’t get rid of.
Diabetic ketoacidosis occurs and whilst it can be treated, if its not treated early enough it can be fatal.
Non-diabetics have a series of bodily processes which sense when ketone concentration gets to high.
When they recognise levels increasing they set in motion steps to reduce the levels of ketones in your blood.
The first step is to release insulin, when insulin is released it does a number of good things:
- It slows the amount of fat you burn
- It limits the amount of ketones the body produces
- It increases the amount of ketones you pee out
These preventative steps happen when ketone levels get to around 4-5mmol/dl, way before ketoacidosis could ever be dangerous.
This is what prevents ketone levels getting out of control and answers the “is ketosis dangerous?” question!
So we’ve unequivocally answered the million dollar question…is ketosis dangerous?
Now that you understand why it’s impossible for you to produce a dangerous level of ketones the next time some smartass tells you you’re diet is dangerous you can school them on the FACTS about ketosis and ketoacidosis!