Acidosis and the ketogenic diet

In today’s article, we will look at the topic of acidosis. What does acidosis mean? Is there possibly a connection with a ketogenic diet?

Many diseases or general health problems are related to eating habits. The proper diet may alleviate or even eliminate some conditions, whereas the wrong one may cause or worsen them. 

In a world with so many different cultures, there are just as many different eating ways. But some of these habits can be fatal to our health. For example, the typical Western diet rich in unhealthy fats and sugars is considered harmful for our bodies.

On the other hand, the ketogenic diet holds many positive effects on our well-being and quality of life. But what about acidosis?

What Is Acidosis?

There are two types of it, one is respiratory, and the other is metabolic. Respiratory or breathing-related acidosis manifests as shortness of breath, elevated blood pressure or palpitations, because of an undersupply of oxygen. Other symptoms include general confusion and weakness.

The main cause of the undersupply of oxygen is the ineffective exhale of carbon dioxide, which acidic and remains in the body unintentionally. 

There’re a number of factors that can cause this process, including bronchial asthma, disorders of the respiratory regulation center in the brain, long-term respiration, or lung flatulence, for example.

So, if not enough CO2 is excreted, our body tries to compensate for this through the kidneys by excreting more acid metabolites through them. Resulting in increase urination. However, if this is not sufficient, without medical countermeasures, the blood’s pH value will drop considerably, which may even lead to death.

Metabolic acidosis occurs less frequently than respiratory acidosis. It is most noticeable in the form of increased deep breathing. As a result, our body tries to exhale more acidic CO2 to compensate for hyperacidity.

The reason for metabolic acidosis is an overload of the body’s buffer systems, which causes the pH value in the blood to drop. 

Acidosis can also be caused by acute or chronic renal insufficiency, which impairs the excretion of acid by the kidneys. A special case in this regard is diabetic ketoacidosis, in which the breath smells strongly of acetone.

How Do You Recognize And Correct Acidosis?

Acidosis can be detected relatively easily by a blood gas analysis. Respiratory and metabolic acidosis can be distinguished with the specific bicarbonate values and the carbon partial pressure.

If there are even a few acidosis signs, you should immediately seek medical attention.

Treatment consists of three factors:

  • Relief of symptoms
  • Reduction of excess acid
  • Elimination of the cause of acidosis

Ketosis Vs. Ketoacidosis – What Is The Difference?

Ketoacidosis, as a unique form of metabolic acidosis, is a complication of type 1 diabetes mellitus. In such a disease, the body is no longer able to produce its insulin. And dependent on an external supply. 

An insufficient insulin supply can lead to the production of ketones in large quantities, resulting in ketoacidosis.

Ketosis and the production of ketones, on the other hand, are not harmful. Ketosis is induced when you reduce carbohydrates’ consumption, usually to less than 50g per day, and fat intake is considerably increased with moderate protein consumption. 

So, the body uses fats as energy sources, which it can effectively use in ketones. And this is completely harmless within the framework of a balanced and healthy ketogenic diet.

What ketone levels are normal?

The amount of ketones found in the blood – or breath is different from a person to another. People who do not follow a ketogenic diet have quite low ketone levels, usually below 0.6 mmol/L in the urine and blood.

Those who start to follow a ketogenic diet their body slowly begin to produce more and more ketones. Then the ketone levels gradually rise to above 0.6 mmol/L. Then, once the body is fully in ketosis, levels settle between 0.6 and 3 mmol/L in the urine and between 0.6 and 1.5 in the blood. These levels are ideal when ketosis is desired.

But, when the body is starving and enters ketosis, due to ancient mechanisms that used to be used for self-preservation during prolonged periods of starvation, our body is in what is called starvation ketosis. In this state, even more, ketones are produced, and the levels are now between 3 and 5 mmol/L in the urine.

At ketone levels that exceed five mmol/L in the urine and 3 mmol/L in the blood, it slowly becomes dangerous. At the very least, the risk of ketoacidosis increases from that point on. If blood glucose rises above 250 mg/dL, you should call a doctor immediately.

For values above 10 mmol/L in the urine and above 3 mmol/L in the blood, ketoacidosis occurs can accrue. And in this is the case, you should seek medical attention immediately.


Acidosis and ketosis differ considerably in terms of ketone levels. To check whether you are actually in healthy ketosis, you should regularly measure the ketone values. 

And as a rule, a properly executed ketogenic diet should not lead to acidosis unless you suffer from diabetes mellitus type 1.