10 Signs and Symptoms That You’re in Ketosis

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The ketogenic diet is a popular, effective way to lose weight and improve your health.

When followed correctly, this low-carb, high-fat diet will raise blood ketone levels.

These provide a new fuel source for your cells and cause most of the unique health benefits of this diet (1, 2, 3).

On a ketogenic diet, your body undergoes many biological adaptations, including a reduction in insulin levels and increased fat breakdown.

When this happens, your liver starts producing high numbers of ketones to supply energy for your brain.

However, it can often be hard to know whether you’re in ketosis or not.

Here are 10 common signs and symptoms of ketosis, both positive and negative.

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People often report bad breath once they reach full ketosis.

It’s actually a common side effect. Many people on ketogenic diets and similar diets, such as the Atkins diet, report that their breath takes on a fruity smell.

This is caused by elevated ketone levels. The specific culprit is acetone, a ketone that exits the body in your urine and breath (4).

While this breath may be less than ideal for your social life, it can be a positive sign for your diet. Many ketogenic dieters brush their teeth several times per day or use sugar-free gum to solve the issue.

If you’re using gum or other alternatives like sugar-free drinks, check the label for carbs. These may raise your blood sugar levels and reduce ketone levels.

Summary The ketone acetone is partly expelled via your breath, which can cause bad or fruity-smelling breath on a ketogenic diet.

Ketogenic diets, along with normal low-carb diets, are highly effective for weight loss (5, 6).

As dozens of weight loss studies have shown, you will likely experience both short- and long-term weight loss when switching to a ketogenic diet (5, 7).

Fast weight loss can occur during the first week. While some people believe this to be fat loss, it’s primarily stored carbs and water being used up (8).

After the initial rapid drop in water weight, you should continue to lose body fat consistently as long as you stick to the diet and remain in a calorie deficit.

Summary Fast weight loss commonly occurs when you start a ketogenic diet and severely restrict carbohydrates.

One of the hallmarks of a ketogenic diet is a reduction in blood sugar levels and an increase in ketones.

As you progress further into a ketogenic diet, you will start to burn fat and ketones as the main fuel sources.

The most reliable and accurate method of measuring ketosis is to measure your blood ketone levels using a specialized meter.

It measures your ketone levels by calculating the amount of beta-hydroxybutyrate (BHB) in your blood.

This is one of the primary ketones present in the bloodstream.

According to some experts on the ketogenic diet, nutritional ketosis is defined as blood ketones ranging from 0.5–3.0 mmol/L.

Measuring ketones in your blood is the most accurate way of testing and is used in most research studies. However, the main downside is that it requires a small pinprick to draw blood from your finger (9).

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