Help with Ketones

[poper77]

Heres a little background first: My a1c is 6.1. My TSH is 1.0 so everything is pretty much in control. I started losing weight for no reason so then I got scared I would gain it back and have been watching what I eat/eating less. I have also been REALLY tired, and wasn't drinking enough water because it is winter and I am cold. Now I discovered that if I test for ketones early evening I have a trace!! As far as I know I am not sick, my bs were not high. Does this have anything to do with the not drinking enough? I read that if your not eating enough that your body will start burning stored fat and you will ketones; but I don't think I am starving myself....

[Jan B]

Since nobody has answered yet . . . my guess is that you need to drink more water. There may be something else going on (infection, etc.?), but it is amazing how drinking more water corrects many things. I'm a little rusty on ketone knowledge, but I've only had them show up when my bg had been running high. Granted, I don't test for them like I should.



About 10 years ago, a doctor had me convinced I was about to go on dialysis and had about 4 years left to live . . . I was just dehydrated and I still do not have kidney disease.

[REDLAN]

Ketones are produced when your body is unable to break down fats completely. ketones are manufactured mostly by the liver, and as far as I know they are only produced (in significant quantities), when your liver is also synthesising glucose (gluconeogenesis).

what happens is that burning fat and synthesising glucose compete with each other, so if your body is synthesising glucose, it can't burn fats. The liver responds by turning fats into ketones, which can be metabolised by other cells in the body particularly the brain and heart.

Essentially ketone production is an emergency response to low glucose/glycogen - it occurs during starvation, (or extreme dieting), very low carbohydrate diets (10g or less per day), and strenuous exercise.

It also occurs during periods of insufficient insulin - insulin suppresses gluconeogenesis. Run out of insulin and your liver starts producing glucose - BG's rise, ketones appear in the blood, and you have classic ketoacidosis.

conceivably you could also produce ketones, if your BG's were running low, and your liver lacked sufficient glycogen - which could happen if you were low-carbing.

the causes I would look at...

1) are you having sufficient carbs

2) are you having sufficient calories for your needs

3) are you borderline hypoglycemic for long periods

4) if you are on MDI, does the basal give you sufficient coverage.

[BlueSky]

... I started losing weight for no reason so then I got scared I would gain it back and have been watching what I eat/eating less. ..... I read that if your not eating enough that your body will start burning stored fat and you will ketones; but I don't think I am starving myself....
Is your weight stable? If you are losing weight, you can expect to have some keytones. Drinking water might flush them out more quickly, but it won't stop you burning fat. Work out how many calories you need every day (you can use this calculator Estimated Calorie Requirements (http://www.exrx.net/Calculators/CalRequire.html)) and add up the calories in what you are eating. Maybe you just need to eat more.

[poper77]

I think it could be the combination of the not enough water and losing weight...Although I am watching what I eat I am definately eating more than 10 carbs a day. I haven't been low or high for long periods of time either.
Is it bad to have a trace of ketones if your blood sugar is not high? From what I read anyone who is losing weight will have ketones?

[BlueSky]

.... Is it bad to have a trace of ketones if your blood sugar is not high? ...
No, small amounts of keytones are normal. Most people will produce keytones overnight, when fat reserves are drawn on to provide energy. People on low-carb diets are often in dietary ketosis - consumed fat/protein is broken down and used before being stored. Keytones are only a problem if they are caused by inadequate insulin, in which case blood sugar is usually very high.

Large amounts of keytones are toxic and and can cause heart failure. But the body normally produces small amounts of them to provide a steady energy supply.