Ketosis and ketoacidosis are they the same thing or are they actually
completely opposites? I'm gonna explain that so you get it once and for all
coming right up so many people are trying the ketogenic diet and they're
getting great results they're losing weight the reversing insulin resistance
they're feeling great but there's still a lot of apprehension and some people
think that oh well maybe I'll try it for a for a little while but I'm scared to
do it long term because I've heard so many terrible things about it and all of
those things are untrue but the one that comes up the most frequently is that a
lot of medical doctors and people who are supposed to know better they throw
out that word ketoacidosis that's what diabetics get and that can
kill you so don't you don't want to get in ketosis so we want to clear that up
because if you're informed you should know a whole lot better than to say
anything like that so medical doctors they've been to school they really
should know better for the layperson I can understand if
it's a little bit frightening and confusing so we're gonna look at all
these we're gonna check out piece by piece how they compare and if they have
anything in common or if they're completely opposite so first of all
ketones is the only thing that they have remotely in common because both
conditions produce a little more ketones than people who eat the standard
American diet but in what we want to call nutritional ketosis or a healthy
state of ketosis that you induce in a healthy person we're a non diabetic
person from eating low carb diets you're going to develop an amount of ketones in
the blood of about 0.5 to 3 and most people are going to be probably around 1
the the really hardcore people who cut their carbs way way down and who do
intermittent fasting they might be able to
push it up towards two and a half or three but probably not totally
consistently so that's a very low very controlled level of ketones we want to
contrast that with someone who goes into a full-fledged fast if you do a water
fast for a week or if you're so unfortunate that you're having to endure
starvation because you're just isn't any food now your ketones might get up to
five but that's about the highest that they can get as long as you have any
functioning insulin in your body in ketoacidosis which happens to diabetics
primarily type 1 diabetics where you have zero insulin where the body has
completely lost its ability to produce insulin that level of ketones can get up
all the way up to 20 to 30 millivolts so we're talking about 10 times higher than
you could induce it by cutting carbs and living a ketogenic lifestyle and
probably 20 times higher than the typical level of ketones so even though
there are some ketones in common we're talking about a completely different
level then let's look at blood sugar so when you do ketosis your blood sugar is
low to normal it's gonna be in the ideal range but it's going to be on the low
side of normal so that's going to be what we call pretty much a perfect blood
sugar that's what you get when you don't eat a bunch of carbs and your body finds
the balance that is the healthiest for you same thing is starvation then you're
not your body still has the ability to break down protein and fat and produce
some blood sugar so you're not going to get extremely low it's going to be on
the low end but it's gonna be in the normal range or close to it in diabetes
in uncontrolled diabetes like we're talking about here that blood sugar is
gonna go sky-high it's going to go into several hundred it's going to go into
many many times the normal range and these people are
very often they're going they're being rendered unconscious very often this is
a type one diabetic who doesn't know that they're diabetic yet they're just
feeling bad being brought to the hospital and they're passing out and
they have really high ketones and very very high blood sugar so let's look at
insulin in ketosis you have low to normal insulin because it perfectly
matches the amount of blood sugar you have low to normal insulin because there
is a low to normal need for insulin your body produces exactly what it's supposed
to same thing in starvation but in type 1 diabetes you have zero insulin you
have none and that's the whole problem that's the only way that this problem
can develop is when you have zero insulin and because of that the blood
sugar runs way way high the other thing is that both ketones and blood sugar are
controlled by insulin so if you have some amount of insulin the ketones can
never run very high because the insulin is controlling that as well but when you
have zero insulin there is nothing to control those ketones and because you're
burning fat as your only source of fuel plus you're breaking down some proteins
there are no carbs being burned even though your blood sugar is that high
you're not burning any carbs so your body is fully starving and you're
burning all the fat but there is no insulin to control the ketones so now
your ketones go into a dangerous dangerous level so let's think about
this from the other direction what's the insulin need again here it's low to
normal because it matches the blood sugar same thing in starvation but
here's the problem in the diabetic we have a sky-high need we have an infinite
need we have an enormous need for insulin but we have none that's the
problem their stuff this enormous discrepancy
with what's needed from what the existing reality is we look at pH and
that's where this disease this pathological condition gets this name is
called ketoacidosis because your blood gets very very acidic and your blood has
to be maintained at a pH around seven point three six five and the last digit
could vary a little bit but it has to be very very precise that's the only place
you can be healthy and in ketosis you're eating a lot of normal food you're
eating a lot of vegetables you're getting plenty of minerals you're eating
a wide variety of foods you're just not eating carbohydrates so your body has
lots of resources to regulate your pH and you're gonna be if you eat healthy
food you're going to be at in normal pH the person in starvation is probably
going to start slipping a little bit toward acid because they don't eat any
food they have a little more ketone but they also don't have any resources their
body is running out of stuff to to manage things and the pH in the
ketoacidosis in the diabetic ketoacidosis is turning lethal it is
dropping enough that this person is dying this is a medical emergency
they're being brought in to the emergency room on a stretcher and
hopefully if they get to them in time they'll save their lives without medical
intervention this person is dead no exceptions
physiology how is the body working how are all the metabolic processes being
managed well in nutritional ketosis they're being perfectly balanced there
are no all the needs are met and the body can manage everything that's needed
perfectly the blood sugar is managed to insulin is managed the ketones are
managed the pH is managed so this is a very healthy person if they eat healthy
food the starving person their physiology is
not sustainable because they're not eating so they can go on for four weeks
or maybe a couple of months but slowly they're gonna be dying if they don't
replenish anything the health of the starving person is kind of a little
dichotomy there because short-term it can be very powerful healing you can
allow your digestive tract and your digestive organs to recover so a lot of
people do and extend it fast to heal their body but even so it's not
sustainable and beyond a point their health is going to be declining because
they're not providing the body the nutrients they need and of course in
ketoacidosis their physiology is in total chaos there's nothing that's
working everything is is going downhill it is sinking it is dying their health
like we've talked about this is a medical emergency and these people would
die every time unless you can get them to a hospital and get them some insulin
injected the key thing to understand is that this is normal physiology this is
controlled physiology everything every parameter is where it should be based on
what we are doing and we can sustain this long term whereas here we have zero
insulin the person is starving they have no access to their blood Sugar's zero as
a result the ketones are running into a lethal pathological level we have a sky
high we have an enormous need for insulin and we have zero that's why this
is not the same thing that's not even close they are actually the complete
opposites because here we have a low insulin need here we have an infinite
insulin need here we have the appropriate amount of insulin which
matches the sugar here the insulin has no match to
the blood sugar so when someone says that they're the same thing they just
don't understand what they're talking about so hope that was helpful please
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ketogenic diet they want to try this out but they're scared they don't have
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