Keto And High Protein In Blood: Is There A Link?

The keto diet is a popular, effective way to lose weight and improve health. It involves eating a high-fat, moderate-protein, and low-carb diet, which forces the body to burn fat and use an alternative metabolic fuel source. While the keto diet has many benefits, it may also cause some side effects, such as keto breath, constipation, and high cholesterol. One of the key markers of the keto diet is an increase in ketones in the blood, which are chemical byproducts that provide a new fuel source for cells. However, it is important to note that too much protein can impair ketone production and kick someone out of ketosis. This is because protein digestion triggers the release of insulin, which decreases ketone production. Therefore, it is crucial to monitor protein intake while on the keto diet to ensure it does not affect ketone levels and cause high protein in the blood.

Ketosis and ketoacidosis

Ketosis

Ketosis is a natural metabolic state that the body enters when it doesn't have enough glucose from carbohydrates to burn for energy. In this state, the body starts burning fat instead of glucose, leading to elevated ketone levels in the blood. Ketosis is generally safe and can be induced by fasting, following a low-carbohydrate diet, or adhering to a ketogenic diet. It is often the goal for people on the keto diet, as it helps with weight loss and can have additional health benefits.

Ketoacidosis

Ketoacidosis, on the other hand, is a serious and potentially life-threatening complication, typically associated with type 1 diabetes. It occurs when the body produces dangerously high levels of ketones, making the blood too acidic. This condition arises when there is a lack of insulin, causing the body to break down fat into ketones too rapidly. The high levels of ketones and glucose in the blood can impair the function of the brain and other organs and must be treated as a medical emergency.

Differences

The key difference between ketosis and ketoacidosis lies in the level of ketones in the blood. Ketosis usually occurs when the body doesn't have enough carbohydrates, whereas ketoacidosis is often due to insufficient insulin levels, particularly in people with type 1 diabetes. Ketoacidosis is a dangerous condition that requires immediate medical attention, whereas ketosis is a natural metabolic state that doesn't typically require medical intervention.

Ketones in the blood

Ketones are substances produced in the liver when fat cells break down in the blood. This breakdown of fat for fuel and the creation of ketones is a normal process for everyone. However, when the body cannot use glucose as a fuel source because there is no insulin or not enough insulin, fat is used as fuel instead. When this happens, ketone bodies build up in the blood, causing ketosis and potentially progressing to ketoacidosis, a form of metabolic acidosis.

Ketosis is a metabolic state characterised by elevated ketone levels in the blood. It occurs when your body burns fat instead of glucose, and is often the goal of those on the keto diet. However, it is important to understand the difference between ketosis and ketoacidosis. The latter is a very serious, life-threatening condition that can affect people with diabetes. Diabetic ketoacidosis (DKA) is associated with sudden and severe high blood glucose, a severe insulin deficiency, and a disruption of the body's acid-base balance. Excess ketones and glucose are dumped into the urine by the kidneys in an effort to flush them from the body. This causes increased urination, thirst, dehydration, and a loss of electrolytes. Symptoms may also include rapid breathing, shortness of breath, a fruity scent to the breath, nausea, vomiting, fatigue, confusion, and eventually coma.

If you have diabetes, it is important to monitor your ketone levels, especially if you have symptoms associated with ketoacidosis. Testing your blood or urine to measure your ketone levels is simple and cheap, with at-home kits available for both types of tests. In people who do not have diabetes, blood ketones are usually ordered when someone has symptoms associated with ketosis or ketoacidosis, such as those with alcoholic ketoacidosis or prolonged starvation.

A ketone blood test measures the amount of ketones in the blood. This test is typically used to diagnose ketoacidosis. A normal test result is negative, meaning there are no ketones in the blood. A positive result indicates the presence of ketones and may be due to alcoholic ketoacidosis, diabetic ketoacidosis, uncontrolled blood glucose in people with diabetes, a low-carbohydrate diet, or other reasons.

Ketones in the breath

Ketosis is a metabolic state that occurs when your body doesn't receive enough carbohydrates for energy and starts burning fat for fuel instead. On a keto diet, your body undergoes biological adaptations, including a reduction in insulin levels and an increased breakdown of fat. As a result, your liver starts producing high levels of ketones, which are chemical byproducts that serve as a new fuel source for your cells.

One of the signs that you've entered ketosis is a change in the smell of your breath, often described as fruity or similar to nail polish remover. This is caused by the presence of acetone, a type of ketone, in your breath. Acetone breath, or "keto breath," can be an unwanted side effect of the keto diet and may indicate high levels of ketones in the blood. While it is usually harmless, in people with diabetes, it can be a sign of a serious condition called diabetic ketoacidosis (DKA).

Keto breath typically occurs within days or a week of starting a low-carb diet and usually goes away as your body adjusts to the lower carb intake. This might take a couple of weeks, but there are some things you can do to help reduce the odor in the meantime:

• Increase your water intake: Drinking plenty of water can help flush ketones from your body through urination.
• Lower your protein intake: As your body breaks down protein, it produces ammonia, which can contribute to bad breath.
• Practice good oral hygiene: Brushing your teeth twice a day and flossing daily can help reduce the odor coming from your mouth.
• Mask the odor with mints and gum: Sugar-free mints and gum can help disguise the smell of keto breath.
• Bump up your carb intake: Slightly increasing your carbohydrate intake can help eliminate keto breath, but be careful not to increase it so much that you're kicked out of ketosis.

Insulin and glucagon

Some cells use glucose as energy, while others, such as liver and muscle cells, store excess glucose as glycogen, which is used for fuel between meals. About 4-6 hours after eating, the glucose levels in the blood decrease, triggering the pancreas to produce glucagon. This hormone signals the liver and muscle cells to convert stored glycogen back into glucose and release it into the bloodstream for cells to use for energy.

This feedback loop is constantly in motion, keeping blood sugar levels from dipping too low and ensuring a steady supply of energy. When blood sugar levels are too high, the pancreas secretes more insulin, and when they drop, it releases glucagon to raise them. This balance helps provide sufficient energy to the cells while preventing damage from consistently high blood sugar levels.

If the body cannot maintain this balance, diabetes and other conditions can result. In people with type 1 diabetes, the pancreas does not produce insulin or does not produce enough, requiring daily insulin intake to keep blood sugar levels in check. Type 2 diabetes is characterised by insulin resistance, where the body makes insulin, but cells do not respond to it properly, leading to higher blood sugar levels.

For keto dieters, it is important to understand the impact of these hormones on ketone production. Protein digestion triggers the release of insulin and glucagon. Insulin decreases ketone production, while glucagon stimulates it. The ratio of these hormones determines how protein intake affects ketone levels. If insulin levels are higher, ketone production will likely be reduced, while consistently higher glucagon levels will lead to ketosis.

Constipation

The keto diet involves a drastic reduction in carbohydrates, which are a common source of fibre. This can lead to digestive issues such as constipation. The diet is typically low in fibre, and individuals following it may also consume more dairy, which can be difficult to digest and lead to constipation. Additionally, with reduced consumption of fruits and vegetables, water intake may decrease without being noticed.

To treat and prevent constipation while on the keto diet, it is recommended to:

• Increase water intake.
• Consume more fibre-rich, low-carb foods, such as non-starchy vegetables, berries, artichokes, and blueberries.
• Reduce dairy intake if it is suspected to be causing constipation.
• Exercise regularly, as it can help regulate bowel movements.
• Retrain the bowel by drinking enough fluids and establishing a regular time for bowel movements.

It is important to note that constipation can be a symptom of the "keto flu", which refers to the flu-like symptoms that can occur during the transition into ketosis. These symptoms include fatigue, headaches, and gastrointestinal discomfort.

Frequently asked questions