In recent years, ketosis has been popularized by the ketogenic (keto) diet.
The Dangers of Ketosis
Ketosisis a normal metabolic process but can be dangerous under certain conditions.
Your body then starts using ketone bodies made from stored fat.
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It May Cause Dehydration
Dehydration is a common early side effect of ketosis.
Fortunately, it’s usually short-lived and treatable.
You may experience dehydration early on while in ketosis because of changes inelectrolytesthat influence hydration.
Research shows that the kidneys may excrete more sodium than usual from days two through six of ketosis.
Over-the-counter pain medications can also treat aheadachewhen necessary.
It Can Cause Constipation
Some people experienceconstipationwhile in ketosis or following the keto diet.
Ketosis may cause constipation and other digestive issues to arise due to the extreme nature of the diet changes.
Constipation may also be brought on by simply eating fewer calories while on the keto diet.
Afiber supplementmay be helpful for some people, while others may need to use alaxativeorenemato find relief.
Talk with your healthcare provider about how to safely use laxatives and enemas.
They are typically seen early in ketosis (the first several days).
An electrolyte imbalance may occur when the levels of one or more electrolytes are too low or too high.
Hyponatremia (low sodium) and hypomagnesemia (low magnesium) are common electrolyte imbalances in ketosis.
Electrolyte imbalances may be due to dehydration, excretion of ketone bodies and electrolytes, and lowmicronutrientintake.
Electrolyte imbalance symptoms may include:
Electrolyte replacement beverages and supplements are typically consumed to treat low electrolyte levels.
In the case of high electrolyte levels, certain medications or extra fluids may help.
Not everyone in ketosis will experience symptoms of an electrolyte imbalance.
Your healthcare provider can provide further guidance.
It may occur in the first few weeks of starting the keto diet and reaching ketosis.
Increasing your intake of water and electrolytes may help treat the keto flu.
If you get the keto flu, talking with a healthcare provider about ways to feel better is best.
Carbohydrates have the most direct effect on blood sugar levels.
Talk with your healthcare provider for individualized guidance.
It May Cause Cardiovascular Risks
Research suggests that the keto diet may increase the risk of specific cardiovascular issues.
To assess your cardiovascular risk, consider having a healthcare provider perform a lipid panel.
Your risks may decrease after stopping the keto diet.
It May Cause Kidney Issues
Ketosis can negatively impact your kidneys, potentially leading to acute or chronic issues.
What Causes Ketosis?
Ketosis triggers when your body usesketone bodiesfor energy instead of carbohydrates.
Testing your blood or urine for ketones can usually confirm ketosis.
It typically occurs in diabetes, known as diabetic ketoacidosis (DKA).
Both ketosis and ketoacidosis involve high levels of ketones.
However, ketoacidosis is life-threatening.
Signs of ketoacidosis include the following:
Seek immediate medical attention if you have signs of ketoacidosis.
Delaying treatment may be dangerous.
Carbohydrate sources tend to be from non-starchy vegetables and small amounts of berries.
Summary
Ketosis is when your body turns fat into ketone bodies to use as fuel.
It does this when carbohydrates are too low to be used for energy efficiently.
Research regarding the safety of ketosis is ongoing.
The ketogenic diet has made ketosis highly popular over recent years.
However, there are many possible short- and long-term side effects of ketosis and the ketogenic diet.
You should aim to reach ketosis safely.
The best way to do this is by getting help from a healthcare provider, like a registered dietitian.
2022;119(1):84-88.
2020;12(8):e9639.
MedlinePlus.Fluid and electrolyte balance.
2020;12(10):e10796.
doi:10.7759/cureus.10796
National Institute of Diabetes and Digestive and Kidney Diseases.Low blood glucose (hypoglycemia).
Kiani AK, Dhuli K, Donato K, et al.Main nutritional deficiencies.J Prev Med Hyg.
2022;63(2 Suppl 3):E93-E101.
doi:10.15167/2421-4248/jpmh2022.63.2S3.2752
Popiolek-Kalisz J.Ketogenic diet and cardiovascular risk - state of the art review.Curr Probl Cardiol.
2023;17(1):sfad274.
Published 2023 Nov 7. doi:10.1093/ckj/sfad274
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of kidney stones.
Harvard T. H. Chan School of Public Health.Diet review: ketogenic diet for weight loss.
2021;13(4):1187.
Published 2021 Apr 3. doi:10.3390/nu13041187
FoodData Central.Nuts, almonds.
FoodData Central.Avocados, raw, all commercial varieties.
FoodData Central.Fish, salmon, Atlantic, wild, cooked, dry heat.
FoodData Central.Beverages, protein powder whey based.
FoodData Central.Blueberries, raw.
