Hi there! I'm Dr. Emily Carter, and I'm an endocrinologist. My area of expertise is in hormones and the diseases that affect the endocrine system. Ketones are something that we encounter quite often in our practice, so I'm happy to speak with you about them today.

## What are ketones?

Let's start with the basics: what exactly *are* ketones? In simple terms, ketones – also called ketone bodies – are a type of fuel that your body produces. This happens when your body doesn't have enough of its primary fuel source, which is glucose (sugar).

You see, your body is a remarkable machine that's built for survival. When it senses that it's not getting enough glucose from the foods you eat, it has a backup plan. It turns to stored fat for energy instead. This process, called ketosis, is how ketones come into play.

During ketosis, your body breaks down fat stores into fatty acids, which then travel to your liver. In the liver, these fatty acids undergo a transformation, becoming ketones.

There are three main types of ketones:


1. Acetoacetate: This is the first ketone produced during fat breakdown.

2. Beta-hydroxybutyrate (BHB): Your body converts most acetoacetate into BHB, which is the primary ketone your body uses for energy during ketosis.

3. Acetone: This ketone is a byproduct of acetoacetate breakdown and is responsible for the distinct fruity odor on the breath that some people experience during ketosis.

## What causes ketone production?

Now that we understand what ketones are, let's delve into what causes their production. As I mentioned earlier, the primary driver of ketone production is the availability of glucose in your body. When glucose is scarce, your body shifts gears and starts producing ketones.

Here's a closer look at some common causes of ketone production:


1. Dietary Changes: The most common cause of ketone production is a significant reduction in carbohydrate intake. Carbohydrates are broken down into glucose, which is your body's preferred energy source. When you drastically limit carbs, your glucose levels drop, signaling your body to start burning fat for fuel, leading to ketone production. This is the premise behind many popular low-carb diets, such as the ketogenic diet.


2. Fasting: When you fast, whether intentionally (intermittent fasting) or unintentionally (skipping meals), your body goes through a similar process as it does with low-carb diets. Without a steady supply of glucose from food, your body turns to fat stores for energy, resulting in ketone production.


3. Prolonged Exercise: During prolonged or intense physical activity, your body can deplete its glycogen stores, which are the storage form of glucose in your muscles and liver. When this happens, your body may start producing ketones to fuel your muscles.


4. Medical Conditions: While dietary changes and fasting are the most common causes of ketone production, certain medical conditions can also lead to elevated ketone levels. These conditions can disrupt your body's ability to use glucose effectively, forcing it to rely more on fat for energy. Some examples of these medical conditions include:

* Type 1 diabetes: This autoimmune condition prevents your body from producing insulin, a hormone that helps your cells use glucose. Without insulin, glucose can't enter your cells, leading to a buildup of glucose in your bloodstream and a shortage of glucose for energy. This prompts your body to produce ketones as an alternative fuel source.

* Diabetic ketoacidosis (DKA): This is a serious complication of diabetes that occurs when ketone levels rise dangerously high. DKA is a medical emergency and requires immediate treatment.

* Other hormonal imbalances: Conditions that affect hormone production, such as hyperthyroidism (overactive thyroid), can also lead to increased ketone production.


5. Medications: Certain medications, such as corticosteroids, can also increase ketone levels in some individuals.


6. Alcohol abuse: Chronic and excessive alcohol consumption can interfere with your body's ability to produce glucose, leading to ketone production.

It's crucial to understand that ketone production in itself isn't necessarily a bad thing. In fact, it's a natural and often beneficial metabolic process that allows your body to adapt to different energy sources. However, excessively high levels of ketones can be harmful, especially in individuals with underlying medical conditions.

If you have any concerns about your ketone levels or experience symptoms like unexplained weight loss, excessive thirst, frequent urination, fatigue, or fruity-smelling breath, it's essential to consult with a healthcare professional to determine the underlying cause and receive appropriate guidance.

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Without the right amount of insulin, glucose starts to build up in the blood stream and doesn't enter the cells. The cells burn fat instead of glucose, and ketones form in the blood and spill into the urine. Some causes of high blood sugar are: Missing an insulin dose or skipping some oral medications.read more >>