Are Ketones Toxic and Dangerous?

T-Bone Steak and Spinach Cooking in a Cast Iron Skillet
Are Ketones Toxic and Dangerous?
A lot of people believe that they are.

It's no secret that the majority of journalists who report on low-carb diets slant their stories to try and show that ketones and the state of nutritional ketosis are toxic and dangerous. 

Since human nature looks to journalists as authoritative, most of what people read or hear from news sources is taken as the absolute truth. But is it? 

Will eating low carb actually give you a heart attack or stroke?

The anti-ketogenic crowd enjoy confronting those on a Keto diet, justifying their position by appealing to the amount of dietary fat allowed on Keto. Their behavior is not really surprising because Keto does look like it's higher in fat than a standard, balanced diet.

But this is because the U.S. government agencies and panel individuals responsible for setting the dietary guidelines for Americans are way behind the curve.

What I didn't expect, however, was the reaction I got from one of my friends when she learned I was following a ketogenic diet.

After taking a couple of glances at one of the Atkins books I had sitting on my coffee table (I don't really remember which one), she proceeded to lecture me about the dangers and toxic nature of ketones.

Her emotional reaction to the Atkins book told me that she was aware of what the Atkins Nutritional Approach was, a low-carb diet, but she really didn't understand the biology and science behind ketogenic eating. Nor did she actually know what low carbers eat on a regular basis.

Even though what we know today is still extremely limited, as far as the science is concerned, a keto diet isn't dangerous. It just uses a different metabolic pathway than most low-calorie diets do. 

Plus, the body has safety features built in to prevent you from going into ketoacidosis, what most people are actually afraid of. 

As long as your insulin response is still intact, your ketone level won't go high enough to become toxic, even if you're insulin resistant. The body won't allow you to accumulate too many ketones.

Apparently, my friend didn't know that. 

If she did, she wouldn't have felt so driven to save me from eating Keto. However, she didn't come up with her misconceptions by herself. She had lots of help.

Public Conception of Ketosis is a Myth

There is a huge group of people who have similar misconceptions about ketosis. 

These myths are driven by journalists who find more value in getting higher ratings and creating controversy among their readers than simply reporting facts. What started out as an objective occupation is anything but that today.

In addition, the Food and Drug Industries are also involved in creating the distorted image the public has of low-carb diets. Low carb, and other whole food diets that can improve insulin sensitivity, are not good for profits. 

If you're confused about the state of dietary ketosis, and you're wondering if ketones are toxic or dangerous, here's what you need to know to set the record straight and enjoy a little peace of mind.

Why Was My Friend Afraid of the Atkins Diet?

My friend was diagnosed with Type 2 diabetes a few years ago, and for some reason (probably some personal research she did on the Internet), she thought that dietary ketosis and the ketoacidosis seen in Type 1 diabetics were the same thing.

I sat there quietly and listened to her opinion. 

I allowed her to express her viewpoint, unhindered, because it wasn't worth opposing her perspective. There was nothing I could say that would make her change her mind, so my time was better served listening and learning what I could from her.

Two People Sitting in an Office, Chatting
Listening to others is how we learn about ourselves.
It's also how we learn to pinpoint what others need.

At the point in her argument where she expressed confusion regarding her cholesterol levels returning to normal, while still being severely overweight, I could see it in her face. 

Like the rest of the world, she didn't get it. 

She couldn't wrap her mind around the idea that sugar and eating too many carbohydrates were responsible for her cholesterol problems, and not dietary fat.

Can a Moderate-Carb Diet Lower Cholesterol?

I know what you're thinking:

If she wasn't eating a low-carb diet, why did her cholesterol levels return to the normal range?

Because she did lower her carbohydrates significantly from what they used to be, and the degree of carbohydrate restriction was severe enough to correct her particular cholesterol issues.

Her actions were what Dr. Atkins would call a step in the right direction. 

She lowered her carbohydrate intake enough to see positive changes in her cholesterol numbers, but not enough to enter the state of nutritional ketosis, or the optimal keto zone as it's called today, As a result, she wasn't able to enjoy its benefits and blessings of reduced hunger.

Hence, her continued obesity.

What are the Benefits of Dietary Ketosis?

Ketosis sets up a very unique chemical reaction in the body. Ketosis:
  • drastically lowers your basal insulin level
  • forces the liver to use the body's fat stores to create ketones to fuel the brain
  • trains the body to use fatty acids for fuel
  • causes hunger to disappear or dramatically reduce
  • greatly elevates your mood and feelings of well-being
With all of these benefits, why are so many folks afraid of entering into ketosis? Wouldn't the physical state of ketosis be a dieter's dream situation?

Of course it would.

But here's a little secret you might not know:

The dieting industry and their marketing companies don't want you to get thin. 

If you reached the weight you want to be, you won't need to keep buying their diet products. The weight-loss industry earns their living off your continual ignorance, diet cycling, and failure to keep the weight off.

You see, the first fuel the body uses for energy purposes is carbohydrates. When you eat carbohydrates, including vegetables, the body burns those carbs for fuel first, rather than your body fat.
  • Nutritionists know this.
  • The medical profession knows this.
  • Even the dieting industry knows this. 
Yet they still try to keep your old metabolic pathways going along as they always have, insisting that even if you have insulin resistance, you still need plenty of carbohydrates in your diet to keep the fires of metabolism burning properly.

That's hogwash! 

How Ketones are Made by the Liver

The truth is this:

When you eat more carbs than your body can immediately use, the only choice your body has is to turn those carbohydrates into glycogen and store them in the liver. However, your body can only store so much glycogen. 

If your glycogen stores are full and you eat more carbs, your body will then turn that glucose into triglyceride and store it in your fat cells for later on.

When no carbs are eaten, the body uses the glycogen stored in the liver to keep your blood glucose level steady. It will also use glycogen if you are under stress, such as during mild exercise or when you enter a frustrating or fearful situation. 

Stress causes an immediate need for extra fuel, which is why you don't want to get too concerned with what the bathroom scale is doing. Making your weight important will simply keep you in a glucose-burning state.

When glycogen stores are about half-depleted, the body ramps up protein oxidation. This increased burning of amino acids saves whatever glucose is available for the brain. Within a few days, however, the liver has to switch to using fat to save muscle wasting. 

Ketones are a by-product of breaking down adipose tissue or dietary fats into fatty acids. These ketones can provide fuel for the brain or your muscles during intense activity, and in the very beginning of your low-carb diet, ketones also fuel your body organs and systems. 

This is why body fat is stored in the first place. 

Body fat provides energy when the body enters a starvation or fuel-lacking situation. However, our modern society rarely reaches a point where glycogen is in short supply. Breaking down fat always results in ketones, regardless of your diet.

When glycogen goes down, your body creates ketones, the carbon fragments of incomplete fat molecules being broken down.

Essentially, when the ketone-making process is consistent, it converts your body from being a mostly carbohydrate-burning engine to a fat-burning engine -- what going on a diet and losing weight is all about.

So fearing ketones is downright silly because they are produced whenever you use stored body fat. 

They are also produced when the body metabolizes dietary fat, so a high ketone blood level doesn't mean you're burning body fat. It just means your brain hasn't used those ketones yet.

On a standard low-fat diet, you make fewer ketones than you do on a keto diet, due to the higher amount of glucose and less fat available for energy on a low-fat high-carb diet.

So What's the Fuss About Ketones Really About?

Ketoacidosis is a serious condition, but it only occurs in Type 1 diabetics. According to the American Diabetes Association, ketoacidosis in a Type 2 diabetic is extremely rare.

This is because Type 1 diabetics cannot make insulin. 

Those who do produce a little insulin don't make enough to encourage the body's cells to pull glucose from the bloodstream into themselves quick enough, so blood glucose level rises. This no-insulin defect in the endocrine system is an autoimmune condition and can only be overcome by injecting insulin. 

It can't be corrected through pills or diets.

It's true that ketones are acidic, and that if too many build up in the bloodstream, the acidity can cause complications, and even death. However, this situation only occurs in Type 1 diabetics because it's due to:

  • the total lack of insulin response
  • not eating enough food
  • uncontrolled blood glucose levels
  • and dehydration  
What most low carbers don't know:

Insulin keeps the number of ketones made by the liver under control. 

In a normal individual, when too many ketones build up in the bloodstream, the body secretes insulin to bring those numbers back down to a healthy level. In non-diabetics, this insulin secretion occurs before the bloodstream reaches a maximum of 8 mmol/L.

In the presence of insulin, excessive acetoacetate ketones are dumped into the kidneys and excreted in the urine because high insulin levels means that glucose is available. Further ketone production is put on hold until the amount of beta-hydroxybutyrate ketones that have backed up in the bloodstream are used by the brain and muscles.

With normal insulin function, the state of ketoacidosis never materializes because in a Type 1 diabetic, without an insulin response, their blood concentrations of ketones can reach as high as 20 mmol/L. Something that never happens in a non-diabetic.

Ketones are Not Toxic or Dangerous for Non-Diabetics

When you are on Keto, the excess ketones made from eating large amounts of dietary fat will back up in the bloodstream. Those are the ketones you measure. However, the body keeps a close eye on the amount of ketones backing up and uses insulin to control the situation. 

This is why going too high in blood ketones can actually be counterproductive to what you're trying to do.

If insulin is secreted due to your blood ketone level being too high, body fat mobilization will STOP until enough ketones have been used to bring the level back down into the safe zone.

Unless you are a Type 1 diabetic, or an alcoholic, you have nothing to worry about.

A ketogenic diet is not toxic. Nor is it dangerous at the levels of ketones that a carbohydrate-restricted diet, or even typical fasting, produces. 

A Keto diet is perfectly safe. 

It's also safe for those with diabetes because Ketoacidosis is not triggered by diet, unless you miss a meal or forget to take your regularly scheduled insulin injection.

Insulin does need to be dialed in by your doctor to match the level of carbohydrates, proteins, and fats you eat on a routine basis, but that's true of any dietary program when you have Type 1 diabetes.

Keeping a close eye on what you eat and how much insulin you take is not peculiar to low-carb diets.