The Difference Between Ketosis and Ketoacidosis

When you hear these two terms it’s easy to see how they can be confused. The confusion also stems from the fact that the two are both metabolic processes involving the breakdown of fats in the body (plus they look and sound like similar words).

The truth is ketosis and ketoacidosis are two completely different things.

Ketosis and the Ketogenic Diet

Ketosis is a normal metabolic process in which the body has a high fat-burning rate. It is a healthy and natural state your body enters when your body is running on fat rather than glucose1.

The state of ketosis occurs when ketone levels are raised in the blood due to the conversion of fats into fatty acids and ketones. This happens when the body runs out of carbohydrates – usually because a person hasn’t eaten in a while, for example during fasts, or they eat a very low-carbohydrate diet – leaving little sugar to convert into glycogen. Without glycogen, the body breaks down fat cells for energy.

A low-carb, high fat diet, also known as a ketogenic diet, is necessary to enter and stay in ketosis long-term.
When you eat a low-carbohydrate diet, your body enters the metabolic state of ketosis within 2 days but it can vary from person to person. There are many benefits 2 to being in longer-term ketosis including:

lowered triglycerides levels

no spikes in blood glucose levels

greater mental clarity

lowered blood pressure and cholesterol

reduced food and sugar cravings

weight loss

Ketoacidosis – The Body in a State of Toxicity

Ketoacidosis is a metabolic state of toxicity. It occurs when the body fails to regulate ketone production resulting in severe accumulation of keto acids which cause the pH of the blood to decrease substantially making the blood more acidic.

The most common causes for ketoacidosis are Type 1 Diabetes, prolonged alcoholism and extreme starvation which can result in diabetic ketoacidosis (DKA), alcoholic ketoacidosis and starvation ketoacidosis respectively. It must be noted that ketoacidosis is rarely seen outside of Type 1 Diabetes.

DKA – Diabetic Ketoacidosis

In DKA, the lack of insulin prevents absorption of glucose which can cause uncontrolled ketone production which can lead to dangerously high ketone and glucose blood levels. If the ketones are not excreted quickly enough the blood becomes acidic and the acidity can cause damage to organs.

DKA usually develops over a period of 24 hours. Blood tests will likely show hyperglycemia (very high blood sugar). Major symptoms include:

nausea and vomiting

excessive thirst and urine production

abdominal pain

Diabetic ketoacidosis occurs in under 1% of people with Type 1 Diabetes annually3.

One is Dangerous & The Other is Not

Ketoacidosis is a dangerous state while nutritional ketosis is when the body and brain are using ketones as a fuel source safely and efficiently. Ketosis can be achieved by reducing daily carbohydrate intake to below 50 grams.

If you have type 1 diabetes, you may still be able to eat a ketogenic diet. Please consult with your doctor and if they approve a trial run, you will be able to try the diet under their supervision, closely monitoring your health and blood.

Is Long-Term Ketosis Good?

Although there have not been many long-term (greater than 1 year) studies on the effects of nutritionally induced ketosis, dozens of short-term studies4 have shown positive results – far better results than low fat diets – including weight loss, increased HDL levels (good lipids), decreased small LDL levels (bad lipids), decreased triglycerides, and many more. A 5 year study5 also showed no adverse effects on patients on a ketogenic diet.

Ketogenic diets encourage eating less preservatives, sugar, processed foods and encourage more whole foods like vegetables, dairy, fresh meats, saturated and monounsaturated fats and oils into the diet6.

There is no need for calorie counting, making low-carb diets far easier to maintain. Much of the time, a low carb diet becomes a way of life instead of simply a diet.

For more information on the ketogenic diet,
read our Full Guide to the Ketogenic Diet
and our 5 Tips for Low Carb Success.