8 ketosis symptoms and signs: The good and bad

8 ketosis symptoms and signs: The good and bad

06/20/2018 - Keto Diet - 0 Comments - Old / Redirected

A ketogenic diet—or keto diet for short—is a high-fat, low-carb diet that’s getting all sorts of celebrity endorsements. It’s a fairly logical diet as well, which is probably why it’s also pretty popular with normal people.

The keto diet works by drastically reducing the carbohydrates that we eat and increasing the fat intake, forcing our body to burn fat as an alternative energy source. For that to happen, glycogen, which is a stored form of glucose derived from carbohydrates, has to be reduced to as little as possible from the body. We’d be able to do just that by minimalizing the amount of carbohydrates that we eat. When the glycogen stores are depleted, our body is forced to burn fat to generate energy for us to function on. Our body goes through a process called ketogenesis to produce energy from the fats and oils that we eat by producing ketones. So what is ketosis? The answer is when our body is running on ketones, we’ve achieved ketosis. Although some cells in the body have to be run on glucose, ketogenesis produces enough glucose to power those cells. Typically, you go into ketosis within 48 hours since your body could only store 2-days’ worth of glycogen.

Needless to say that achieving ketosis is the ultimate goal of going on a keto diet. There are many health benefits to be reaped from going through ketosis, including better metabolism, improvement in cardiovascular diseases and diabetes. It might also improve the levels of HDL cholesterol, which is known as the “good” cholesterol. It’s fairly well-known that the higher the levels of HDL cholesterol, the lower the risk of heart diseases.

The problem with this is that most of us suck at listening to our own bodies without the knowing what to look for. So, here are 8 signs of ketosis.


Ketosis symptoms and signs


#1 Weight loss and appetite suppression

Let’s be honest, weight loss is basically why most people start on the keto diet. It sounds like the dream: to eat fats to burn fats. Luckily for us, weight loss is definitely going to be the first surefire sign of ketosis.

Our body stores excess glucose in our liver and muscles in the form of glycogen. Glycogen and water are best buds—wherever one goes, the other follows. When we limit the amount of carbs we eat, our body doesn’t get new glucose to burn through. So, it burns through the stored glycogen for energy, which in turn flushes away the water that is attached to the glycogen as well.

It’s super motivating to see the numbers on the scale go down. However, it’s important to remember that it’s because of the water that was retained for ages with the glycogen. After that, it’s about persevering with the diet and continue eating fewer carbs to avoid another build-up of glycogen. As long as ketosis is maintained, by theory, we should be able to lose weight in a healthy and stable manner.

As mentioned, ketosis is achieved when ketones are produced in our bodies. Ketones help lower our body’s demand for insulin. Going a few steps back, insulin is the hormone that signals the brain to take glucose from the bloodstream when energy is needed. Basically, it tells the brain that we should eat more carbs and sugar, which glucose is derived from, for energy. Since we replace a bulk of the carbs with fats as well as eliminating sugar in the keto diet, we reduce the need to produce a lot of insulin. Less insulin equals feeling hungry less frequently, which equals eating less. Less insulin also means that you don’t get crazy sugar cravings now since your body doesn’t use glucose as the main source of energy anymore. As a bonus, replacing carbs in our diet with fats has the added benefit of not wanting to eat as much. So, if you don’t feel like eating too much, you’re definitely experiencing a sign of ketosis. With the exception of protein, fats are the most satiating macronutrient to eat. If we’re satiated, we eat less and thus lose more weight. You’d definitely have to eat healthy fats and oils like coconut oil, avocado and olive oil though! Eating a bucketful of fried chicken instead of rice is not going to do anything for your waistline.


#2 More ketones in your blood, breath and piss

One sign of ketosis is when you have higher levels of ketones in your system. When you go through ketosis, you’ll produce more ketones as a by-product of the breakdown of fats. The question here is how we know if the level of ketones in our system actually increased.

Unfortunately, there’s no way you’d know about your ketone levels without a test of some sort. The most effective way is to use a ketone blood strip. It’s relatively easy to use. You’ll need to prick your finger for a spot of blood, place it on the meter and wait for the meter to tell you the exact amount of ketone in your bloodstream. For reference, an optimal amount of ketones in your blood for weight loss would be between 1.5 mmol/L to 3.0 mmol/L.

The ketone blood strip is also especially useful in case of ketoacidosis, which is a life-threatening condition that could develop in the span of 24 hours due to abnormally high levels of ketone in the blood. Although the ketogenic diet is recommended to diabetics due to the reduced carbohydrates, people with type I diabetes are very vulnerable towards ketoacidosis since they can’t produce insulin. On the contrary, it’s very rare for an otherwise healthy person to develop ketoacidosis.

Since ketone is also excreted through your breath and urine, you could also determine if you’re in ketosis by using a urine test, which is the second most reliable test for ketones. You’d use it like you use a pregnancy test—pee on the stick and wait for the meter to change colour according to the amount of ketones you have in your body. Since you’ll expel different chemicals such as urea and water in your body through urination, it could produce mixed or unclear results. Another sign of ketosis is having a fruity smell, a.k.a. keto breath, in your mouth. However, it’s highly subjective and unmeasurable since you could mistake a normal day’s bad breath for keto breath.


#3 More focus and concentration!

Having more focus or concentration is one of the reasons why the keto diet is so popular. The exact cause of this is unknown but there are a few speculations. By cutting out sugar and carbs, we don’t get frequent cravings and reminders to eat. We also don’t get the sugar crashes that often come with eating candies and snacks, since those are forbidden fruit in the ketogenic diet. Without the sugar crash, you might actually be able to focus on work in the afternoon without thinking about that chocolate chip cookie in the pantry!

Another interesting perspective on why we focus better with ketosis is because when our body’s at ketosis, ketones are produced at a steady level, providing constant energy to our brain. It allows us to focus deeper and have better concentration since ketones do a great job fuelling our mind and body. On the flip side, some scientists think that this perceived increase in focus and concentration is just because we’re so used to feeling weak and tired in the initial stages, everything moderately good after that is an amazing boost. Simply put, a lot of scientists think that the focus and concentration perk from ketosis is just a placebo effect, even though keto enthusiasts have sworn by it.


#4 Feeling fatigued from keto flu

No, it’s not the same as getting a swine or bird flu. And yes, it’s weird to talk about feeling tired after boasting the improved concentration you get from ketosis.

Keto flu is a cluster of flu-like symptoms that your body would experience when it’s trying to put behind your carb-eating days and being “keto-adapted”. It could take anywhere from a week to a month for your body to learn the ketogenic ways. So when does keto flu start? If you feel groggy and fatigued after starting with the keto diet, you’re definitely coming down with symptoms of ketosis flu. This is due to the confusion your body feels when it couldn’t find the glucose that it’s used to for energy. Think of it as your body going into power-saving mode. Since it can’t find glucose or glycogen, it’ll take a while for it to learn that it could survive just as well on fat.

It might be also because we lose a significant amount of water along with the glycogen stores when our body undergoes ketosis. Electrolytes in the water are essential to provide electrical energy for nerve-transmission and bodily functions. Without the optimal level of electrical energy needed, we’d conserve energy by not firing as many neurotransmitters, thus slowing down our responses and reactions. A lack of electrolytes may also cause muscle cramps and pains.

It’s crucial to replenish water and electrolytes in our body when going through ketosis because we lose so much of it so quickly. Drinking more water is the way to go. Although sports drinks normally have a ton of electrolytes in them, they are usually chocked full of sugar as well for that extra burst of energy. It’s not recommended in a keto diet since the whole point of it is to eliminate sugar from your diet. Some people find that drinking broth or adding an extra pinch of salt to the food they eat helps as sodium is a kind of electrolyte as well.


#5 A dip in performances

Because of the fatigue, a temporary dip in work, academic or athletic performances may also be a sign of ketosis.

Since your body is still trying to adjust to using a new energy source, you might not feel as physically fit as you were before cutting carbs. As a matter of fact, a lot of athletes experience a drop in performance when starting the keto diet. Most of the athletes who reap the benefits of the keto diet are endurance athletes like long-distance cyclists or marathon runners though. Athletes who rely on short bursts of energy tend to fare worse on the ketogenic diet. If you exercise a lot and with more intensity, you might experience a longer period of keto flu since you’re used to expending a lot more energy than the average person.

Much like the average flu, the suffering is only temporary. It could take anywhere from a week to six weeks to shake that feeling of sleepiness. Experts recommend staying away from strenuous activities for the first few weeks to conserve energy.


#6 Toilet troubles

A sign of ketosis is when you suddenly find the toilet to be your new best friend.

Like anything new you introduce to your body, it takes a while for your body to register and be accustomed to unfamiliar things and experience you put it through. It doesn’t help that your body is expelling water like mad at this stage either. The expulsion of water combined with a dramatic, increased consumption of fats cause diarrhoea in most people. It could also be caused by dehydration due to the loss of water. Thankfully, it’s temporary. All you have to do in the meantime is to drink a lot of water to replenish liquid and electrolytes in your body. It helps to take some fibre supplements as well. As soon as your body gets used to the new diet, you’re good to go.

Some people swing the other way and experience constipation instead. Many blame it on the increased amount of meat. However, it’s most likely because they’re eating a large amount of food that they weren’t before starting the keto diet. One such example is the consumption of full-fat dairy. Full-fat dairy contains casein, which could be digested with a special enzyme called rennet. Since human stomachs don’t produce rennet, it could cause constipation. Some of the other foods that keto beginners tend to eat in large, unprecedented amounts are vegetables such as broccoli, kale and cabbage as well as nuts, which are notoriously difficult to digest because of the indigestible short-chain carbohydrates in them. These are probably just possible reasons though. Every person can stomach different foods; some are more sensitive to changes and some are the lucky ones who could poop as usual every day regardless of what they eat.


#7 Bad breath

If you wake up one day wondering if something died, look no further—it’s probably your breath.

As mentioned, one tell-tale sign of ketosis is having a bad breath. When ketone is produced in large quantities, acetone is produced as a by-product. If that sounded familiar, it’s because acetone is a chemical mostly used in cleaning agents like nail polish remover and super glue remover. In small quantities, it smells fruity. But it makes your breath smell like hospital antiseptic when it’s produced more. It could also be the protein we eat instead of carbs. When protein is broken down, it produces ammonia, which smells like urine or hair dye. Either way, it’s not the most pleasant smell to wake up to.

Most keto-veterans said that it’s most obvious in the morning right after waking up. It’s most likely because of the happy marriage between ketosis and the bacterias in your mouth. The best way to combat this is to have a good brushing in the morning. If you’re worried about the smell throughout the day, a good idea would be to carry sugar-free gum and pop one in your mouth when you’re feeling especially paranoid. Water would also help eliminate bad breath since it lubricates your mouth and helps get rid of bacteria. The most important thing here is still to be persistent and keep on with the diet. Keto breath normally goes away after a week or so. All it takes is for your body to be okay with ketosis.


#8 Insomnia

Ever feel tired and wide awake at the same time? That’s a sign of ketosis.

The main reason for this is that you get more energy when you cut carbs from your diet. Carbs are not known as comfort food for no reason. It maintains the insulin levels in your blood, effectively maintaining energy equilibrium and making sure that our brain has the protein it needs. It also boosts the serotonin levels in your brain via an amino acid. A noteworthy effect of serotonin is that it helps improve sleep quality and well-being. When we cut out carbs, the insulin levels get disrupted and the entry of the amino acid that releases serotonin in made harder. Therefore, it could cause a lack of sleepiness and even a spike in energy.

Some people might experience difficulty falling asleep while others might wake up earlier than usual. While it seems like fun, in the beginning, to have a few extra hours to be productive in the morning, not being able would eventually wear out your mental strength. It’s also not fun to wake up in the morning with a seemingly permanent brain fog.

If it’s too unbearable, some experts recommend easing into the keto diet by reducing the amount of carbs instead of drastically reducing it. It could help your body to get used to it without putting it under intense stress. Light exercises are also recommended to help your body gets through insomnia while under a ketogenic diet. It helps to balance the sleep rhythm in your body as well as exhausting energy. You could also do yoga or meditation to relax and to help with the other signs of ketosis.

Like all signs of ketosis, you’d be able to sleep like a baby when your body is adapted to the ketogenic diet. Most people reported better quality sleep after their body got used to ketosis. Some even said that they needed less sleep than before and are actually able to use the extra time to do something. According to a study done by the International League Against Epilepsy, it is found that although the number of hours of sleep is less, the quality of sleep improved. Ultimately, as everyone’s sleep cycle is different, ketosis would affect every individual differently. One thing’s constant throughout the observations though. Insomnia during ketosis normally goes away after a few weeks, so if it’s possible, it’s best to let your body ride it out.


Everybody’s different

The thing about diets is that it affects everyone differently. Although these are a few of the universally recognized signs of ketosis, it’s best used as a guide instead of a one-size-fits-all definite list of ketosis symptoms. The severity of these symptoms varies from person to person as well.

There is such a thing as optimal ketosis, where the ketone levels in your blood is optimal. The word optimal here is used loosely, since it depends on what you want to achieve with the keto diet. For high performances and athleticism, high levels of ketones are better as it provides more energy for strenuous physical activities. However, if your goal is to lose weight and to live a healthier lifestyle, you could experience it at a lower level of ketones. The benefits of ketosis are also best reaped when your body has got used to running on ketones instead of glucose.

Although you don’t have to count calories when you’re on the keto diet, it’s always good to observe how your body reacts to the keto diet and modify accordingly. Some people might need to taper their intake of carbs instead of reducing it immediately and some might need to exercise earlier in their diet than others. Most of the adverse ketosis side effects are just symptoms of a transitional period between the changing of primary fuels of your body, meaning that they’d disappear once your body is running comfortably on ketones. On that note, the key point here is to listen to your body for ketosis symptoms and signs and persevere.  



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