Ketones

Ketones are also known as ketone bodies which are byproducts of the breakdown of fatty acids. The fat will be converted into fuel and it is a normal process in a human body. During the conversion process, ketones are produced. If there is sufficient insulin in your body, the glucose levels in the blood will increase. If the body fails to use glucose for energy, it will break down the fat. The conversion of fatty acids into ketones will take place in the liver and they will be released into the bloodstream.

Your body should get enough carbohydrates from the food so that the cells will get the energy. Ketones are produced by the liver in the burning process of fat. The fat burning will be controlled automatically when you take a balanced diet and maintain a healthy lifestyle. when you cut your calories or carbs, there will be an increase in ketones.

In the normal state, the ketones will be metabolized so that their count will be low. They will appear in the urine. The ketone production will increase if there is a deficiency of glucose in the body. The excess ketones will be flushed out of the body from the urine. If you are on a low-carb diet, ketones will build up in the blood. Some people will go on a low-carb diet to achieve the weight loss goals.

Ketones Symptoms

If there are high levels of ketones in the bloodstream, you will experience various symptoms:

-  Abdominal pain (prominent in children)

-  Decreased perspiration

-  Dry, cool skin

-  Fatigue

-  High blood glucose

-  Rapid weight loss

-  Bad odour on the breath (similar to nail polish colour)

-  Nausea and vomiting

-  Confusion

-  With the accumulation of ketones in the blood, ketones will also go through the urine. During this process, the ketones will take off potassium and sodium salts as well. When the sodium and potassium levels in the body come down, the patient will suffer from nausea and vomiting.

-  More water will be drawn into the urine and it will result in dehydration.

-  The patient will suffer from a bout of flu and there will be a stomach upset as well. As the body loses water very quickly, there will be a loss of electrolytes. If the dehydration occurs within hours, it will be very serious.

-  If there is extreme stress, DKA may occur in type 2 diabetes patients. However, it is very rare.

-  Ketoacidosis is more common in people suffering from type 1 diabetes. If the symptoms of Ketoacidosis are witnessed in the body, they will escalate very quickly. There will be fruity breath smell, excessive thirst, stomach pain, fatigue, nausea, and confusion.

-  If your body runs out of insulin, you will develop Diabetic ketoacidosis. The symptoms of DKA in diabetic patients include feeling very thirsty, feeling sick, tummy pain, fast and deep breath, feeling tired and the requirement to pass the urine at regular intervals.

Ketones Causes

-  Glucose is an essential element in the human body. If your body is low in glucose, the fat present in the body will be converted into energy.

-  If there is insulin deficiency in your body, the cells fail to absorb the energy. In this process, the body will break the fat to generate energy. The ketone bodies are the byproducts of the breakdown of fatty acids.

-  If you are diabetic, there is a risk of ketone buildup in the bloodstream.

-  If the ketone buildup is not treated, the people will pose the risk of Diabetic Ketoacidosis (DKA).

-  When you are suffering from ketoacidosis, you will have higher levels of glucose as well as ketone levels.

-  Ketones are found in urine due to various reasons. Some of them include poorly-controlled diabetes, starvation, diabetic ketoacidosis, anorexia nervosa, bulimia nervosa and the ketogenic diet.

-  High fat and low-carbohydrate diet are known as a ketogenic diet. The diet can increase the ketones in the body. However, the formation of ketones will be less than the DKA and there will not be much harm to the body. A ketogenic diet will be used to treat epilepsy.

How is it diagnosed?

-  The production of ketones in the body is termed as ketosis. In this process, there will be the burning of fat instead of glucose. While ketosis is not a concern, excess levels of ketones in the bloodstream is a cause for concern.

-  Ketone test is nothing but a blood test ordered by the doctor to figure out the ketone levels in your blood.

-  The blood test will be conducted after collecting the blood from the vein or from the fingertip.

-  Ketone levels can be determined through the urine tests as well. urine tests may not be accurate as it will take some time for ketones to pass through the urine.

-  If the ketone levels are less than 0.6 mmol/L, it is considered as the low level of ketosis. If the level is in between 0.6 mmol/L and 1.5 mmol/L, it is considered as the mid-range. If the reading is above 1.5 mmol/L, it is treated as a high range.

-  If you have higher levels of blood sugar (240 mg/dL), symptoms of DKA, and suffer from nausea, you should undergo the urine and blood as per the direction of the doctor.

-  The urine should be collected in a clean container and the dip stick should be used to measure the ketone levels.

-  If you are conducting the test for children (who are not potty-trained), the stick can be pressed against the diaper. As there will be special chemicals the dip sticks, the colour will change and the severity of the ketone levels can be understood.

-  Blood ketones can be measured by conducting the test with the at-home meter. The test can be conducted in the same way as you would conduct the finger-stick glucose test.

-  You should consult the doctor if the ketone levels are low to moderate. You should seek immediate medical attention if the ketone levels in the body are high.

Prevention

-  If you are not diabetic and maintain a healthy diet, there will not be any issues ketones or ketosis.

-  Diabetic patients should be aware of the ketone levels in their bloodstream. The ketosis will take place before the ketoacidosis which is also known as Diabetic Ketoacidosis.

-  Your diet will trigger the ketosis. If you are not eating enough or not getting enough insulin, the ketone levels will be very high. If there is insulin reaction during sleeping, there will be a higher ketone level in the morning.

-  As you take low-carb food, the production of insulin will decrease. If the insulin falls short of the requirement, the fat levels will be burned towards the production of energy.

-  Fasting and consuming alcohol will also lead to ketosis.

-  Diabetic patients will high levels of ketones should drink plenty of water and they should avoid physical exercises.

-  Ketone levels can be understood by conducting the dip-stick exam at home. If you use the dip stick, you can find the small, moderate or large amount of ketones as the colour will change appropriately.

-  The blood glucose levels should be monitored on a continuous basis and steps should be taken to control blood glucose levels in the body. If there are excess ketones, they should be dealt with very quickly.

Ketones Treatment

-  To treat the ketosis, insulin therapy will be implemented. The doctor will assess the health condition and most appropriate treatment option will be provided to the candidate.

-  If you get treatment for high ketones, you can avoid hospitalization. You should work with the doctor to manage moderate levels of ketones in the body.

-  If the ketone levels are very high, there will be increased urination. To compensate for the fluid loss, the doctor will place you on intravenous (IV) fluid replacement. The glucose levels in the body will be diluted in this process.

-  If the electrolyte levels are low, the electrolyte replacement should be done. The electrolytes which are supplied in this process include potassium, sodium and chloride. If there is severe loss of electrolytes, the heart and muscle fail to function in a normal way.

-  For moderate to serious cases of DKA, hospitalization is warranted. The fluid and electrolyte replacement will be done when you are admitted to the hospital. The electrolyte levels will be brought to the normal levels through the electrolyte replacement.

-  The urine output will be monitored until the vital signs are normal.

-  You should eat calorie-rich food to flush out the ketones from the body. As you take insulin, you should check the blood glucose level. The blood glucose level and ketone level should be monitored every 3 to 4 hours to stabilize the levels very quickly.

-  Ketones and ketogenic diet will be used to treat common neurological conditions. The conditions which can be treated in this process include epilepsy, Alzheimer’s Disease, Parkinson’s Disease, Autism Spectrum Disorder, Gliomas, Traumatic Brain Injury, Stroke, Multiple Sclerosis, and Amyotrophic Lateral Sclerosis.

Complications

-  Diabetic ketoacidosis (DKA) is a life-threatening complication and it is quite common in people suffering from type-1 diabetes. Ketones are toxic substances and the blood will turn into acidic. If there are high ketone levels in the blood, it should be detected immediately so that the person will not slip into a coma.

-  DKA may take place in people who suffer from type 1 diabetes and fail to take the insulin dose as per the schedule. If a person suffers trauma or injury, there is scope for DKA.

-  If the ketone levels are very high in the blood, there will be a serious impact on your body. It will lead to the swelling of your brain, diabetic coma, loss of consciousness and death.

-  In some patients, an infection may trigger DKA. Hence, appropriate medication will be used to treat DKA.

-  In some cases, the urine ketone strips will reveal positive. However, there will not be ketones in the urine. This condition can reflect in patients who are under medication such as levodopa and sodium valproate. If you are taking vitamin C or on severe dehydration, you will go through the same situation.

-  In other cases, the urine ketone strips may reveal negative while ketones are present in the urine. Some kits will detect acetoacetate and fail to detect ketone. If there are high levels of beta-hydroxybutyrate, the test will be negative.

-  People maintaining high levels of stress and insufficient insulin will have many complications. The ketone levels in the blood will be very high and the treatment should be offered to the patient on an emergency basis. If the ketogenic diet is followed correctly, it will not lead to ketoacidosis. Before following the ketogenic diet, you should consult your physician.

-  the ketogenic diet may not be good for people suffering from hypothyroidism.

Myths

Myth #1: There is no impact on ketone levels by missing the insulin shot

If you miss the insulin injection, there may be a severe impact on your health. The lack of insulin in the body will starve the tissue and it will have an impact on the fat metabolism and ketone accumulation.

Myth #1: Ketones are harmful to the brain

ketones will burn in a different way and the process is different from others. They will improve the mitochondrial efficiency. They play an important role in the energy metabolism. Hence, there is no harm to the brain when your body produces moderate levels of ketones.

Conclusion

If there are excess levels of ketones, the blood will turn acidic. The ketones levels should be monitored at regular intervals and the treatment should be taken as per the guidance of doctors. The ketones in the body will be flushed out through the urine. Hence, you should take IV fluids to compensate for the loss of fluid in the body. If there are large levels of ketones in the blood, you should take emergency medical assistance.

Last updated on : 14-09-2018

Disclaimer : Docprime doesn’t endorse or take any guarantee of the accuracy or completeness of information provided under this article and these are the views strictly of the writer. Docprime shall not be held responsible for any aspect of healthcare services administered with the information provided on this article.

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