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Keto 101

Keto Diet 101: What Can Possibly Go Wrong? Bowels.

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BOWELS:  TOO SLOW [CONSTIPATION]

THIS PROBLEM AFFECTS PATIENTS: on day 3-4

THIS PROBLEM LASTS UNTIL: your bowels adapt to your new diet.

keto diet 101

Drinking salted water prevents the keto flu and also helps with changes happening in your guts. I’m referring specifically to your stool. Constipation and hard bowel movements occur naturally as part of the keto transition process.

With less water, your stools become dehydrated and harder. Drinking salty water helps lessen this problem.  

For the first couple of weeks, patients struggle with what to eat. My salesmanship for high-fat meat must work very well because they do a great job of loading up on fatty, greasy meat.

They produce ketones, but they also get constipated. A few minutes studying the number of carbs found in fruits and vegetables teach you that corn, cantaloupe, peas, bananas, and are all no-nos.   

My new keto patients usually aren’t that familiar with many keto-friendly vegetables. For example, cabbage, Brussels sprouts, and fresh spinach are all great additions to a keto diet.

Sadly, many patients look at me bewildered that others actually eat that stuff. They ate yummy fatty meats, successfully peed ketones and did a little dance. Everything’s awesome until day 4 when they couldn’t poop.

Some patients got so constipated they gave up. Be prepared for this constipation challenge. Drink salt water.  Add cabbage early.

Ingest a spoonful of dry chia seeds with some water every 2-4 hours.  These little seeds swell up into a gelatinous substance and have helped many patients transition. This trick is tried and tested. One tablespoon every 2 hours followed by two cups of water has yet to fail my patients with this problem.

Several said they could not keep up with the spoonful of seeds that often and only made it to six tablespoons before they quit. However, the next day: success!!

If you’re still having a tough time with constipation, try Milk of Magnesia. This over-the-counter medication is the perfect fit for this problem. In the first weeks of keto, magnesium is the most common salt your body will lose. This magnesium-filled liquid medication helps replenish your missing magnesium while boosting your stools to soften up and move along.

BOWELS:  TOO FAST [DIARRHEA]

THIS PROBLEM AFFECTS PATIENTS: on day 3-4

THIS PROBLEM LASTS UNTIL: we figure out the cause of the loose stools.  

Most people on a keto program experience bowel problems in the form of constipation. Sometimes, people experience the other extreme: diarrhea. This is usually due to a pre-existing problem with their system.  

Over the years, the US government and corporations have spent millions of dollars researching ways to help people suffering from all sorts of bowel ailments. These range from irritable bowel to bacterial overgrowth, to leaky gut syndrome. One 1970s study treated irritable bowel syndrome with a high-fat diet.

It took six months for the study’s subjects to become regular. Still, the study showed that a high-fat low-carb diet is one of the cheapest and most effective ways to regulate runny stools and other bowel problems.

Unfortunately, the study was small and was not funded by a big pharmaceutical company. The study did not promote any medication. The outcomes from that old trial were so promising for this taxing problem that it led me to change how I approached my patients with bowel problems.

My experience with patients suffering from irritable bowel has taught me to stick to the plan of peeing ketones for three to four months before they turn the corner.

Did you know your small bowel or small intestines are supposed to be sterile? Sterile-as in no bacteria. Your large intestines are packed with bacteria. But your small intestines are supposed to be sterile. Anxiety, stress and chronic illness all lead to poorly functioning bowels.

Your small intestines can get so messed up that the bacteria normally found at the end of your intestines, in the large colon, wiggle their way into the upper portion of your digestive tract.

The bacteria in the small intestine reproduce without much resistance and grow rapidly. This is called small bowel overgrowth.  

When patients have small bowel overgrowth, it is not uncommon for them to lose out on fatty vitamins normally absorbed there. Because their small bowel gurgles with abundant, unwanted bacteria, they can’t absorb any fat-based nutrients.

I’ve started patients on a ketogenic lifestyle not knowing that they had small bowel overgrowth. A week into the change and they are miserable with uncontrolled diarrhea. They call the clinic upset and declare, “This just is NOT the diet for me!”

After checking their lab results as well as a detailed history, it turns out they often have had loose stools after eating fat for the better part of a decade. These patients report avoiding all fat because it always gives them explosive diarrhea.

Such eruptions after each greasy meal kept them malnourished from their avoidance of fat. They go on for years without understanding what was truly happening to their system. One day, they happen to have their Vitamin D checked. Their results were so low that it could only mean they have not been absorbing any fat for years.

Fat absorption failure means you absorb no fat-based vitamins. Vitamin D is one of those vitamins.

I advise patients of mine who suffer diarrhea after switching to a high-fat diet not to give up. Why? They need this anti-inflammatory diet more than most of my other patients. If you suffer from loose stools or explosive diarrhea after going keto, give your body time to adjust.

Don’t give up! Your bowel has grown used to the low-fat life you used to lead.  The mechanism to absorb fats has been sleepy or even shut down altogether. Turning these cells back on takes time. A few months!

The health of your brain and bowels depend on your ability to persevere. If your bowels flare up when switching to high fat, please know that it is more than just an annoyance. Something more is going on. See a gastro specialist. Extreme intestinal inflammation mentioned above can last weeks.

The lack of adequate fat enzymes also takes times to correct. Give your body time to adjust. Years of this hidden problem led to the chronic swelling of your bowels’ inner lining. It takes time to mend that chronic wound inside your guts.

Keto Diet 101: Solutions Available

If you get diarrhea within days of switching to keto, you have a problem with inflammation or absorption. Don’t quit. Fix it. To tide you over, I recommend the following:

Lomotil:  This over the counter medication slows down bowel movements. Most people cannot put their life on hold to deal with intense diarrhea. It takes time to fix this problem. In the meantime, don’t take all this suffering lying down. Control your symptoms. Take Lomotil. It will settle the symptoms down while we work through the problem without hurting you.  

Kombucha Tea: This ancient drink is bubbly and fermented with healthy live bacteria in it. Most of my diarrhea patients reversed their bowel problems when they repopulated their gut bacteria. Many patients spend thousands of dollars on this process. Save your money.

Drink 1/4 cup of this tea a day until the diarrhea is resolved. Notice that I said ONE-FOURTH OF A CUP.  Too much of that bacteria is often not tolerated by those struggling with bowel problems.

Finally, the surefire antidote that transitions my diarrhea patients through the roughest part can be unsettling for patients to hear: intermittent fasting. Yes, I am referring to the term for NO EATING. Before you transition your body chemistry to keto, any kind of fasting sounds like a strange idea.

Once you produce ketones, your appetite decreases. My diarrhea patients have an unknown injury inside their guts. That lining needs to heal. The answer? Rest. In other words, intermittent fasting. Fasting is a universal remedy for many medical problems.  

When I suggest this to patients, they often resist due to fear of going without food. To help them begin to consider the option, I remind them that animals instinctively fast when they are ill. Rest your guts to allow time for healing. Stop eating.

The ancient Greek physician Hippocrates, regarded as the father of medicine, said this about fasting, “Everyone has a doctor in him; we just have to help him in his work. The natural healing force within each one of us is the greatest force in getting well. To eat when you are sick is to feed your sickness.”

If you want to learn more about understanding the ketogenic diet, check out the book ANYWAY YOU CAN on Amazon or Audible by Annette Bosworth, MD.

RESOURCES:

  1. Mavropoulos, J. C., et al. “The Effects of Varying Dietary Carbohydrate and Fat Content on Survival in a Murine LNCaP Prostate Cancer Xenograft Model.” Cancer Prevention Research, vol. 2, no. 6, 2009, pp. 557–565., doi:10.1158/1940-6207.capr-08-0188
  2. Nikaki K, Gupte GL.; Assessment of intestinal malabsorption; Best Pract Res Clin Gastroenterol. 2016 Apr;30(2):225-35. doi: 10.1016/j.bpg.2016.03.003. https://www.ncbi.nlm.nih.gov/pubmed/27086887

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Keto 101

Keto Diet 101: What Can Possibly Go Wrong? KETO FLU.

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ketogenic diet and intermittent fasting

If you are peeing ketones and feeling fine, skip these next four parts of this articles reviewing what can go wrong when you start a keto diet.

However, if you tried to make ketones and you never turned your strip pink, read these posts.  Or maybe you succeeded for a time, but then something went wrong.

If you are a worrier and you read on the internet all the ways this ‘crazy’ diet supposedly messes up your body, read this.   

Keto-recap: A body fueled by sugar is chronically inflamed and in crisis. It is impossible to drip in the exact amount of carb fuel needed without going over or under your requirements. More than a teaspoon of carbs pushes your body into releasing insulin. When glucose is your fuel, eating too little leads to a steady decrease in your metabolism. Conversely, extra, unused glucose, rings your ‘insulin alarm’ triggering a spike of this hormone and continuing the cycle of inflammation.

Fueling your body with fat means no insulin. You rid yourself of the crisis. Your body produces ketones from fat when the glucose falls low enough. Ketones slip through your system and body putting out fires of inflammation the longer the ketones are around. A state of ketosis reverses inflammation caused by chronic high insulin levels.

As an internal medicine doctor, my job is helping with your health’s ‘long game.’ In other words, chronic disease management. When your body swells on the inside, that inflammation causes trouble. Chronic, slow-growing inflammation creeps into more and more areas of your body.  

After years of too many carbohydrates, your system gets really messy on the inside. But it is stable. Your cell walls become stiff and inflexible. The ‘hoses’ that carry your blood are crusty and can’t be easily stretched or relaxed. Reversing this chronic problem is tricky. The day you flip your energy source from carbs to fat, your body chemistry changes. This sends your crusty, stiff-albeit stable-system into flux.

What can go wrong when a carb addict switches to ketones?

KETO FLU

  • THIS PROBLEM AFFECTS PATIENTS: On Day 2 of producing ketones
  • THIS PROBLEM LASTS UNTIL: Lasts for up to a week.

If you Google any side effects of the Keto Diet, keto-flu tops the list of search results.

This condition got its name because chronically inflamed patients experience flu-like symptoms as they transition. Yep, give up those tasty, sweet carbs, and you will feel like you have the flu. When you get the flu, a ‘bug’ sets up a colony or home inside your body and messes with your system. Those critters invading your body cause lots of symptoms. The invading infection steals your water, drinks your salts, and eats up your sugar. Your tummy aches, in part, because the bugs selected your guts as their new home.

Flu symptoms include a headache, tiredness, dizziness when you stand up, racing heart, nausea, loss of appetite, and feeling rather irritable. When you get the flu, you get dehydrated. That dehydration causes all those symptoms. A body switching from sugar to fat also gets dehydrated. Dehydration causes the symptoms collectively called ‘keto flu.’

What’s so dehydrating about producing ketones? Ketones aren’t the cause. Instead, it’s the lack of all those glucose molecules circulating in your system. Glucose is a large, monster-sized molecule that flows through your veins.

Glucose acts like a sponge and holds onto water as it percolates throughout the body. Each glucose molecule holds onto hundreds of water molecules. Excess bloodstream glucose translates to thousands – even millions – of extra water molecules.

Do the math.  

Check your blood sugar. Is it above 100? For every point above 100, you added thousands of extra monster-sized glucose molecules to the 7 liters of blood you hold. Now, multiply that by the hundreds of water particles clinging to each glucose.

Twenty carbs per day lead to way less glucose in your bloodstream. Less glucose holding onto that circulating water causes you to flush that extra fluid out. Over the course of the first week, I have had patients lose 20 pounds. That’s nearly three gallons of excess water.  

Removing the extra water causes significant weight loss. KETO or the ATKINS diet gets picked on through statements like this: ‘The only way you lose weight on a high-fat diet or Atkins-like diet is because you lose water weight.’ That’s exactly what happens….at first.

Millions of water particles lost their chemical sponges and are gone. Without that sugar, the water flows right out the kidneys. Dehydration is defined by the rapid loss of water. All that extra water inflames or irritates your body. Removing it is the right answer.  

Your ‘flu’ or dehydration symptoms appear when you are caught unprepared for ketosis’ water loss.

This water loss hits your kidneys like a tidal wave. Your kidneys remove water from your blood by adding it to your urine. They ‘steal’ salts from your bloodstream to make this happen.    

Before long, you get a headache and feel really tired. You try to stand up only to suffer sudden dizziness and a pounding heart. Oftentimes, you get crabby. Welcome to the keto flu.

The antidote is simple: eat SALT, drink water and slow down.

Let’s start with salt. Yes, I mean salt. Like the white stuff in the shaker on your table. I prefer pink Himalayan salt or sea salt, but common table salt will do. Salt, like fat, is an overly demonized compound.

Fat and salt are essential to the Keto diet. You need to replace the fluid that belongs in your body. Knowing that keto transition sucks salt and water into your urine should motivate you to add salt to anything you eat or drink.

You get dizzy because there’s not enough fluid in circulation. Replace that fluid by eating and drinking with salt.

If you add plain water back to your system, you will not fix the flu-like symptoms. The water will go in and flush right back out. The salt holds the proper amount of water in your circulation and corrects the dehydration.  Drink salty broth to keep the keto flu away!

The next step is to slow down.

If you are reading this and considering fueling your body with fat, GREAT. Let me help you succeed. If you are a carb addict with a daily intake of more than 300 carb gram, start slowly.  

Begin with zero calories in your drinks for the first week. Once you are successful with that for seven consecutive days, then remove all white foods: No bread, no rice, not pasta, no pastries.  Follow that rule in addition to the no-calories in your drink for seven straight days as you prepare for ‘transition day.’ This plan gives you the space to allow a gentle shift in your body chemistry to prevent the keto flu. This schedule also gives you enough time to clean out your cupboards.

WARNING: BE CAREFUL IF YOU TAKE HIGH BLOOD PRESSURE MEDICATIONS

  • THIS PROBLEM AFFECTS PATIENTS: On Day 2-3 of producing ketones
  • THIS PROBLEM LASTS: up to a week.

If you are on blood pressure medication and you want to get off them, the keto lifestyle is the answer. However, the transition can be dangerous. Prepare yourself.

My patients taking high blood pressure meds must check their own blood pressure at home. Without all those large glucose molecules loaded with hundreds of additional water particles, your body’s circulation volume drops. Not because of blood loss; because of water lost. Lower volume means less pressure! It takes far less medication to control blood pressure when all that water is gone.   

Thanks to the Keto diet, helping patients get off blood pressure medication has never been easier. You must use a home blood pressure monitor though. Check your blood pressure 2-3 times a day when transitioning. As you reduce and remove carbohydrates from your diet, your blood pressure will drop quickly. Be careful. Let your doctor help you remove those blood pressure medicines as quickly as you remove the carbohydrates.

In a matter of five days, I got one patient off of five of his blood pressure meds! This, of course, all depends on how strict you are at following the less-than-20-carbs-a-day rule and how long you have been a carb addict.  

POUNDING HEART

When your heart races inside your chest, a feeling of terror takes over your mind – even if you are a doctor. Your fear is justified. A pounding heart can be a warning of impending death. It signals us to pay attention. If your heart begins to thump inside your chest during ketosis transition, pay attention. Your body is warning you of something.

The most common reason for this symptom is the dehydration mentioned above. Dehydration forces your heart to pump fast and strong. Fix this problem quickly by drinking salted water! Keep doing this until the heart-pounding goes away.

If you have a history of heart arrhythmia or heart failure, you must consult your doctor before you go on a keto diet. If your heart is pounding because of an abnormal rhythm, you can drown yourself in salted water only to make things worse for your heart.

Check out the book ANYWAY YOU CAN on Amazon or Audible by Annette Bosworth, MD for more keto information.

RESOURCES:

  1. Seyfried, Thomas N. Cancer as a Metabolic Disease: on the Origin, Management, and Prevention of Cancer. Wiley-Blackwell, 2012
  2. Siri-Tarino, P. W, et al. “Meta-Analysis of Prospective Cohort Studies Evaluating the Association of Saturated Fat with Cardiovascular Disease.” American Journal of Clinical Nutrition, vol. 91, no. 3, 2010, pp. 535–546., doi:10.3945/ajcn.2009.27725. 
  3. Effect of exercise intensity and starvation on activation of branched-chain keto acid dehydrogenase by exercise; G. J. Kasperek, and R. D. Snider; 01 JAN 1987. https://doi.org/10.1152/ajpendo.1987.252.1.E33
  4. Scott AR1; Joint British Diabetes Societies (JBDS) for Inpatient Care; JBDS;Management of hyperosmolar hyperglycemic state in adults with diabetes; Diabet Med. 2015 Jun;32(6):714-24.   DOI:10.1111/dme.12757

 

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Keto 101

Keto Diet and Kidney Stones: Keto 101.

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keto diet and kidney stones

Keto Diet and Kidney Stones

Kidney stones should be called kidney crystals. That’s what they are: crystals. and the keto diet and kidney stones do sometimes cross paths. Hold on. Don’t run away.  Finish reading about the keto diet and kidney stones.  

  • THIS PROBLEM AFFECTS PATIENTS: 2-4 after their first ketone is made
  • THIS PROBLEM LASTS UNTIL: the rapid weight loss stops. [The blood ketones along with the blood sugars are stable.]

 

ketosis and kidneys image 1

The formation of these crystals deep inside the kidney starts with a tiny chemical attraction between two elements. Your kidney handles a huge volume of these elements every second.

If you want to begin making a kidney stone, the first step is to get dehydrated. Run low on water (dehydration) and the concentration of urine in your kidneys shoots way up. This concentrated waste flowing through your kidneys puts these crystallizing elements really close together. Voila! Your first crystal is made.  

Next, you add one tiny element to that crystal every time your urine becomes concentrated. As you add one element after another, the crystal grows in size as does its power to attract even more elements. Maybe it takes you five years to build that crystal up to a speck. Maybe it takes you ten years. Unless you ‘melt’ your kidney stones away, you keep adding one tiny element after another.  You can even grow multiple kidney stones at the same time.

Change Over Time

Over time, that crystallized spec turned into a tiny pebble. Then a stone. One awful day, that big crystal breaks away from the place where it grew. The crystal tumbles through your waterworks like a boulder. Each tumbler’s sharp edges cut and scrape through tissue causing one of life’s most excruciatingly painful experiences.  

Making kidney stones is painless. No one can feel those tiny changes inside your kidney as the stone grows. Painlessly your stone collects more and more particles. If you want to grow those stones faster, add insulin to the system. A lot of insulin. A high insulin state leads to several changes that are GREAT for growing kidney stones.

If we use a super advanced imaging system to look into the kidneys of adults, almost every person has tiny little kidney stones. They are growing and shrinking all the time. The stones are either adding crystals or slowly melting away. This is constantly happening.

ketosis and kidneys image 1

If your kidney bathes in crystal-growing chemicals, your stones will continue to grow. High sugar levels favor crystal growth. Ketones favor crystal melting. Ketosis shifts the body’s chemistry in the opposite direction of the high sugar state.  

Does this mean ketosis will melt all the stones lurking in your kidneys? Not quite.

The good news: ketosis’ chemistry shift ensures your kidneys’ existing crystals stop growing. Indeed, some of those crystals can disappear over time.

The bad news: Your stone may dislodge before it dissolves.

How come?

When your body produces ketones, kidney stones’ crystals get removed one element at a time. We don’t get to choose which order the elements peel off of that crystal.

 

If you have a stone that has been there for years, your new keto-centered blood chemistry may whittle away at the base of the stone. This could set the big stone free to roll down the tubes of the kidney and bladder system. When that stone is securely fixed to the wall of the kidney system, you have no symptoms. If the stone breaks free, boy, oh, boy will you feel it!  That crystallized boulder rolls downstream sending shockwaves of pain through your back and groin.

Question: Can ketosis CAUSE you to pass kidney stones?

That’s a trick question. It certainly disrupts your body’s chemical balance which can lead to your existing stones melting and, in some unlucky situations, passing. Ideally, your body’s chemical shift would melt stones one element at a time without dislodging them from their current position. But this is not guaranteed.

ANTIDOTE: Don’t cheat! The best way to shake loose a bunch of kidney stones is to go in and out of ketosis a lot. The shift from making the stones to melting the stones unsettles your system.  

If you have no stones in your kidney, then you are fine. You won’t make new stones while on ketosis. If you have a crop of growing kidney stones and don’t know it, beware. If you know you have kidney stones because you have had troubles in the past, you need to commit to this shift in chemistry and stay in ketosis. Pray that the stone melts in an orderly and smooth way. Finally, stay hydrated. A dry kidney is a painful kidney. Never is this truer than when dealing with kidney stones.  

GOUT

  • THIS PROBLEM AFFECTS PATIENTS: 2-4 after their first ketone is made
  • THIS PROBLEM LASTS UNTIL: the rapid weight loss stops

If you’ve ever had a gout attack, pay attention to this section. Gout happens when waste products crystallize within the body’s joints and produce pain when those crystals start to move.

Ketosis significantly reduces your body’s inflammation. It causes your body to adjust. One of those adjustments can involve gout crystals getting dislodged from inside your joints-a gout attack.

Don’t let a history of gout stop you from a keto diet. Gout crystals formed because of the food you ate years ago. Diets high in carbohydrates combined with fatty meat sparked the problem in your joints. When you switch to a high-fat-low-carb diet, the inflammation drops and the process begins to reverse.  As the crystals dissolve, the burden on your joints lessens. But the moment too many crystals move at once, you may spark a gout attack.

Not everybody with a history of gout suffers a flare on this keto diet. If you’ve had attacks in your past, you need this lifestyle change more than others. Those crystals hiding in your joints are just a barometer, an indicator, of all the things that have slowly gone wrong deep inside your system. Your high-carb, high-insulin lifestyle has led to gout. Believe it or not, gout crystals are produced by the body as a quick fix. The body stuffs joints full of these extra crystals for storage to prevent your blood from becoming toxic with excess uric acid.

Your body will store these crystals into every joint possible unless somehow you tip the scales back the other direction. Bathing your system in ketones will reduce insulin and inflammation. This process also dissolves gout crystals. The process of melting such buildup can result in a painful gout flare.

Antidote: Keep your probenecid or your colchicine around. And of course, stay hydrated.

Want to learn more? Check out the book ANYWAY YOU CAN on Amazon or Audible by Annette Bosworth, MD.

RESOURCES:

  1. Mehmood A. Khan MD  John V. St. Peter Gail A. Breen  Guilford G. Hartley John T. Vessey; Diabetes Disease Stage Predicts Weight Loss Outcomes with Long‐Term Appetite Suppressants; 06 September 2012
  2. Stubbs, James, et al. “Macronutrients, Feeding Behavior, and Weight Control in Humans.” Appetite and Food Intake, 2008, pp. 295–322., doi:10.1201/9781420047844.
  3. E. Cersosimo, M. Ajmal, R. J. Naukam, P. E. Molina, and N. N. Abumrad; Role of the kidney in plasma glucose regulation during hyperglycemia; American Journal of Physiology-Endocrinology and Metabolism, Volume 272, Issue 5; 1997 May 01; https://doi.org/10.1152/ajpendo.1997.272.5.E756
  4. I. Alexandru Bobulescu, Naim M. Maalouf, Giovanna Capolongo, Beverley Adams-Huet, Tara R. Rosenthal, Orson W. Moe, and Khashayar Sakhaee; Renal ammonium excretion after an acute acid load: blunted response in uric acid stone formers but not in patients with type 2 diabetes; American Journal of Physiology-Renal PhysiologyVolume 305, Issue 10; 2013 Nov 15; https://doi.org/10.1152/ajprenal.00374.2013
  5. Goldberg, Emily L., et al. “β-Hydroxybutyrate Deactivates Neutrophil NLRP3 Inflammasome to Relieve Gout Flares.” Cell Reports, vol. 18, no. 9, 2017, pp. 2077–2087., doi:10.1016/j.celrep.2017.02.004

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Keto 101

Keto Diet 101: Ketosis and Bad Breath.

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ketosis and bad breath

THIS PROBLEM AFFECTS PATIENTS: When you begin making ketones.

The problem of ketosis and bad breath lasts until the patient is Keto-Adapted (up to 6 weeks). When your body uses ketones, it releases extra units of ketone compounds. Unused ketones flush out of the body as acetoacetate in the urine or acetone through your breath.

Acetone breath is a dead giveaway you’re burning fat for fuel. Acetone smells weird causing metallic- or fruity-scented breath. Surprisingly, many don’t experience this problem at all. Others only have acetone breath for a few days while others can smell the ketones coming out of their sweat and their breath for months on end.

For most people, bad breath lasts for about a month as they adapt to ketosis. The odor usually improves over time as blood ketone levels stabilize in the second or third week.  

Remember: acetone ends up in your breath when lots of extra ketones circulate in your blood. When first transitioning to ketosis, your blood can fill with a whole bunch of ketones waiting their turn to be used as fuel. As your cells ‘remember’ how to use this kind of fuel, more and more cells turn on their ketone-burning parts. At first, only a few cells burned ketones, but by the end of the third or fourth week, many cells throughout the body can burn either ketones or glucose.  

With that improved army of ketone-furnaces inside your mitochondria, less excess compounds float around and in turn fewer acetone fumes out of your mouth. Gradually, your body burns ketones as fast as you make them. With less excess ketones, your breath won’t stink of acetone.

To Deal With Acetone Breath, Try The Following:

#1: GET YOUR TEETH CHECKED. I found it helpful to remind patients that we evolved using ketones. The human race did not evolve eating starches and sugars. Today’s diet fills your mouth with a sugar-bath. It leaves your teeth with tiny pockets where sugar feeds bacteria and other microbes. These hidden cavities allow smelly bacteria to flourish. Cavities and their bacteria are the sources of the long-standing bad breath associated with ketosis.

Please note that the longer you bathe your teeth in ketones, the stronger and healthier your teeth get. Your ancestors kept their teeth for a lifetime by constantly circulating ketones in their blood and spit. Thanks to their high-fat diet, this continued exposure to ketones strengthened their teeth while fighting the bacteria living in their mouths.

#2: DRINK ENOUGH WATER:  Dehydration leaves your mouth dry. Mouth dryness concentrates the power of the bacteria living in your oral cavity. Proper hydration flushes and continually washes your mouth while also diluting the places where bacteria live.

Also, when you drink enough water, you flush ketones from your blood into your urine. You only breathe out acetone when your blood is overflowing with extra ketones. Staying properly hydrated allows your body to get rid of excess ketones through your kidneys. It takes the pressure off your lungs to process ketones and breathes them off as acetone.  

#3: STAY THE COURSE. The best way to keep that acetone fuming out of your mouth is to go in and out of ketosis. Steady ketone production allows the system to adapt and stabilize fully.  Stabilize in this context means that the production of ketones matches the burning of ketones. There will never be a perfect match between these two parts of the equation, but they should get rather close once you have hit your keto-rhythm. The way to mess up this equation is to go in and out of ketosis. That leaves the extra acetone molecules stinking up your breath.  

Hungry for more information on the ketogenic diet? Check out the book ANYWAY YOU CAN on Amazon or Audible by Annette Bosworth, MD.

RESOURCES:

  1. Anderson JC, Measuring breath acetone for monitoring fat loss: Review. Obesity (Silver Spring). 2015 Dec;23(12):2327-34. doi: 10.1002/oby.21242.PMID: 26524104
  2. Toth, Csaba, and Maria Schimmer Zsofia Clemens. “Complete Cessation of Recurrent Cervical Intraepithelial Neoplasia (CIN) by the Paleolithic Ketogenic Diet: A Case Report.” Journal of Cancer Research and Treatment, vol. 6, no. 1, Apr. 2018, pp. 1–5., doi:10.12691/jcrt-6-1-1

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