What are Keytones

Ketone bodies are an energy source that the human body can use, just like the glucose produced after the digestion and decomposition of carbohydrates, proteins, and lipids, it can provide energy for the body.

Due to the rise of the ketogenic diet, people need a basic understanding of the theory, efficacy and applicability of ketone body production in the human body.

So Finally, What are Ketones?

Ketone bodies are an energy source that the human body can use, just like the glucose produced after the digestion and decomposition of carbohydrates, proteins, and lipids, it can provide energy for the body. Normally, the human body naturally produces some ketone bodies, but the concentration is very low. Ketone bodies are one of our body’s four sources of energy, along with fatty acids from fat, amino acids from protein, and blood sugar converted from carbohydrates. Since ketones are one of the four sources of energy, why are they so rarely heard or discussed? This is because ketone bodies rarely appear in our daily food, but our bodies know how to produce them.

How to measure ketone body concentration? Is it better to have a higher concentration of ketones?

We can measure the concentration of ketone bodies from blood, urine or exhaled air. Among them, I think measuring by exhaled breath is the most convenient. In the past, when I was on a ketogenic diet, I used a gas ketone machine to monitor the concentration of ketone bodies to ensure that I was in a state of ketosis.

Ketone body concentration can be roughly divided into three levels:      low, medium, and high

The Low Concentration is the state of a generally balanced diet

The Medium Concentration is the state after a carbohydrate-restricted diet. 

At this time, there is less insulin secretion in the body and more fat is broken down. This is the state that most people want to achieve after adopting a ketogenic diet.

The High Concentration levels refer to ketoacidosis, which is commonly seen in patients with insulin problems.

Ketone bodies and their production mechanism

Ketone bodies are compounds produced by the liver when the human body breaks down fat under hunger, fasting, or certain pathological conditions (such as diabetes), including:

1. Acetoacetic acid (AcAc), the main ketone body in urine.

2. Beta-hydroxybutyrate (BHB), the main ketone body in the blood.

3. Acetone, the main ketone body in breath.

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After being produced, ketone bodies will leave the liver cells and enter the blood, and reach other tissues in the body through the blood circulation. Acetone will be excreted through the respiratory tract, while the other two ketone bodies can be converted back into acetyl-CoA and enter the tricarboxylic acid cycle. . Beta-hydroxybutyrate (BHB) serves as an energy source for most cells in the body, including brain cells.

Comparison of the three ketone bodies with the molecular formulas of glucose.

When the body is under starvation, fasting or certain pathological conditions (such as diabetes), the body does not have enough sugar or glucose to supply energy needs, so fat mobilization is enhanced, and a large amount of fatty acids are absorbed and oxidized by liver cells; at the same time, in order to maintain The blood sugar concentration is stabilized and the gluconeogenesis in the body is also activated. A large amount of oxalic acid, the raw material for glucose regeneration, is consumed, which affects the tricarboxylic acid cycle, another metabolic pathway in which oxalic acid is involved. A large amount of the intermediate acetyl-CoA cannot be consumed and accumulates, thus generating ketone bodies.

Ketone bodies and ketoacids are alternative energy substances that are the degradation products of fat in the liver. In the above situation, insulin levels are low, but glucagon and epinephrine levels are relatively normal. This combination of low insulin and relatively normal glucagon and epinephrine levels causes fat to be released from fat cells.

Fat reaches the liver through blood circulation, is processed into ketone bodies, and then returns to the blood circulation and enters muscles and other tissues to be used as energy substances for metabolism. In normal people without diabetes, the production of ketone bodies is the body's normal adaptation to hunger. Blood sugar levels don't rise too high because there's just the right balance between insulin, glucagon, and other hormones.

Diabetic Ketoacidosis (DKA)

However, the ketone bodies produced by diabetics can be very dangerous and even life-threatening. When insulin is insufficient, fat cells continue to release fat into the blood circulation, and the liver continues to produce more and more ketone bodies and keto acids. An increase in ketoacid levels, causing the blood pH to become too low (acidosis/diabetic ketoacidemia), is a medical emergency and requires immediate treatment.

Symptoms that patients with diabetic ketoacidemia may experience include vomiting, abdominal pain, deep and rapid breathing, increased urination, general fatigue, confusion, and in severe cases, coma. Diabetic ketoacidemia often occurs in people with type 1 diabetes, but in some cases it can occur in people with other types of diabetes. When patients with diabetic ketoacidemia have their blood sugar checked, their blood sugar levels are generally higher, and ketone bodies can be found in blood analysis or urine, which proves that the patient has acidosis.

It is important for people with type 1 diabetes to understand ketoacidosis because they are most likely to develop life-threatening ketone levels. However, patients with type 2 diabetes may develop ketoacidemia if insulin resistance is significantly increased (eg, due to infection or steroid treatment) or if insulin release from the pancreas is significantly reduced.

Ketone testing methods, advantages and disadvantages

The most direct way to know whether you have started ketosis is to measure the concentration of ketones. Measuring ketones every day is very helpful for adjusting your diet and routine, because if you eat hidden carbohydrates, you will soon find that ketones disappear within 24 to 72 hours. It is very important to confirm your plan by directly measuring ketones. There are currently three common inspection methods on the market, and you can choose according to your own needs:

 

1.            Urine test

Advantages Disadvantages

Low cost. Only one ketone body, acetoacetic acid, can be detected.

The operation is simple and convenient. After the body adapts to ketosis, the acetoacetic acid in the urine will disappear.

If ketone bodies can be detected, it means that the body must be in a state of ketosis. Not accurate enough: If urinary ketones are not detected, it does not mean that the body is not in ketosis.

Urine ketone test, convenient and fast. ©keto.tw

2.            Blood tests

Advantages Disadvantages

The most accurate way to test for beta-hydroxybutyrate, which the body primarily uses for fuel. The cost is more expensive and there are fewer stores selling it, so you have to buy it online.

 Needling for blood test is required, causing pain.

Blood ketone test, accurate and reliable. ©keto.tw

 3.           Breath ketone body test

Advantages Disadvantages

The only way to detect ketone bodies (acetone) in breath is positively correlated with blood ketones (beta-hydroxybutyrate). It is not sold on a large scale and is not popular.

The operation is simple and convenient. Different testers have different usage specifications, and there is no conversion standard for respiratory ketones and blood ketones.

The operation is cumbersome and the device must be continuously blown for 10-30 seconds.

Coconut oil and ketones

It is said that coconut oil can help prevent Alzheimer's disease (dementia, cognitive impairment). This is because after the medium-chain fatty acids in coconut oil are absorbed by the body, they will directly enter the liver and be metabolized into ketone bodies (Ketone). This ketone body can provide replacement nutrients to the brain, helping to prevent the brain from gradually dying when it cannot use blood sugar normally. Although eating coconut oil allows the body to produce ketones, the amount of coconut oil must be sufficient for the brain to use it. In addition to eating coconut oil, the Ketogenic Diet also allows the body to use fatty acids to create ketone bodies.