What is the Difference Between Ketosis and Ketoacidosis

The key difference between ketosis and ketoacidosis is that ketosis is a metabolic state when the body does not have enough carbohydrates to be burned for energy and burns fat and makes ketones to use as a fuel, while ketoacidosis is a metabolic state associated with high serum and urine concentrations of ketone bodies due to pathological conditions such as diabetes, high alcohol consumption, and starvation.

Ketosis and ketoacidosis are two metabolic states involved in the production of ketones in our body. However, ketosis is generally safe. On the other hand, ketoacidosis can be life-threatening. Inducing ketosis is the aim of a ketogenic diet or high fat and low carbohydrate diet, which can help people to lose weight. But ketoacidosis occurs when the body produces a dangerously high level of ketones, often as a complication of type I diabetes.

CONTENTS

1. Overview and Key Difference
2. What is Ketosis  
3. What is Ketoacidosis
4. Similarities – Ketosis and Ketoacidosis
5. Ketosis vs Ketoacidosis in Tabular Form
6. Summary – Ketosis vs Ketoacidosis

What is Ketosis?

Ketosis is a metabolic state when the body does not have enough carbohydrates to be burned for energy. In this state, our body burns fat and makes ketones that can be used as fuel. Nutritional ketosis occurs when the human body uses fat instead of glucose as fuel. Therefore, the liver breaks down fat into chemicals known as ketones. Ketones are released into the bloodstream. This makes the body use ketones as an energy source. The ketogenic diet aims to induce nutritional ketosis.

Figure 01: Ketogenic Diet

People go into ketosis by eating food that is normally high in fat but very low in carbohydrates. Following a ketogenic diet has become a popular way nowadays to burn fat and lose weight. Moreover, doctors originally developed this diet in order to treat children with epilepsy as they found ketogenic diet reduces seizures. It also helps people who suffer from diseases such as metabolic syndrome, insulin resistance, type 2 diabetes, acne, cancer, polycystic ovary syndrome (PCOS), and nervous system diseases like Alzheimer’s, Parkinson’s, etc. However, the side effects of ketosis or ketogenic diet include keto flu, fatigue, brain fog, irritability, constipation, trouble sleeping, nausea, stomach ache, dizziness, sugar cravings, cramps, sore muscles, and bad breath. Furthermore, drinking plenty of water can ease some of the above symptoms. In addition, kidney stones due to the keto diet can be prevented by taking potassium citrate.

What is Ketoacidosis?

Ketoacidosis is a metabolic state associated with high serum and urine concentrations of ketone bodies due to pathological conditions such as diabetes, high alcohol consumption, and starvation. The clinically relevant ketoacidosis are diabetic ketoacidosis (DKA), alcoholic ketoacidosis (AKA) and starvation ketoacidosis. In diabetes (type I diabetes), if a person does not have enough insulin, the body cannot move glucose from the blood into cells. In order to fulfil energy requirements, lipolysis occurs. As a result of this, dangerous levels of both glucose and ketones can accumulate in the blood. Moreover, alcoholic ketoacidosis occurs in patients with chronic alcohol abuse, liver disease, and acute alcohol ingestion. Starvation ketoacidosis occurs when the body is deprived of glucose for a prolonged period of time, which causes fatty acids to replace glucose.

Figure 02: Ketoacidosis

The symptoms of this condition include excessive thirst, frequent urination, nausea, vomiting, stomach pain, weakness, shortness of breath, fruity-scented breath, confusion or agitation, fast heart rate, fast breathing, and dry mouth. This condition can be diagnosed through blood sugar level test, ketone level test, blood acidity test, blood electrolyte test, blood alcohol test, urine analysis, chest X-ray, and electrocardiogram. Furthermore, treatments may include insulin therapy, intravenous thiamine, intravenous dextrose, intravenous fluid, replacement of potassium, phosphorus, magnesium, medicines to help alcohol withdrawal, and medicine to help nausea.

What are the Similarities Between Ketosis and Ketoacidosis?

• Ketosis and ketoacidosis are two metabolic states.
• They involve the production of ketones in the body.
• Ketone bodies can be found in the blood in both conditions.
• Ketone bodies are produced from fatty acids in both conditions.

What is the Difference Between Ketosis and Ketoacidosis?

Ketosis is a metabolic state when the body does not have enough carbohydrates to be burned for energy and burns fat to make ketones, which can be used as a fuel, while ketoacidosis is a metabolic state associated with high serum and urine concentrations of ketone bodies due to pathological conditions such as diabetes, high alcohol consumption, and starvation. Thus, this is the key difference between ketosis and ketoacidosis. Furthermore, ketosis is generally safe, but ketoacidosis can be life-threatening.

The below infographic presents the differences between ketosis and ketoacidosis in tabular form for side by side comparison.

Summary – Ketosis vs Ketoacidosis

Ketosis and ketoacidosis are two metabolic states. Both involve the production of ketones in the body. However, ketosis is generally safe, but ketoacidosis can be life-threatening. In ketosis, fat is burned to make ketones when the body does not have enough carbohydrates to be burned for energy. In ketoacidosis, there is a high serum and urine concentration of ketone bodies due to pathological conditions such as diabetes, high alcohol consumption, and starvation. So, this summarizes the difference between ketosis and ketoacidosis.

Reference:

1. Khatri, Minesh. “Ketosis: Definition, Keto Diet, Symptoms, and Side Effects.” WebMD.
2. Ghimire, Pranita. “Ketoacidosis.” U.S. National Library of Medicine.

Image Courtesy:

1. “Ketogenic diet – Concept of a healthy lifestyle” By Marco Verch Professional Photographer (CC BY 2.0)
2. “Diabetic Ketoacidosis” By Gblanchard16 – Own work (CC BY-SA 4.0) via Commons Wikimedia

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