Is Ketosis Dangerous? No, Because Ketosis is not Ketoacidosis.

At this point, I consider myself pretty immune to what internet trolls say to me. I have a pretty tough skin, usually laugh off nonsensical comments, and carry on with my day. This last time was different.  

When checking the social media account for my ketosis supplement company, Perfect Keto, I noticed a rather ridiculous comment. To the best of my memory, the comment said something like this:

“How dare you promote ketosis?! I HATE KETOSIS! My daughter is a diabetic and had to be brought to hospital the other day because she was in ketoacidosis! Shame on you and everyone like who you recommends a dangerous diet that kills people! You are killing people! AGHHH!”  

Not only is this comment wildly misinformed and ignorant, I think comments like this are more dangerous than the promoting the ketogenic diet. When people make comments like this, they use the same scare tactics and lack of facts that have recently overtaken our political system to influence people in not using very beneficial tools to their advantage. Sometimes you just have to use your brain.

The unfortunate truth is that this lady isn’t the only delusional and misinformed one instilling fear into people who are trying to gain benefit from their nutritional choices. Plenty of mainstream doctors also think the ketogenic diet is life threatening.

I’ve recommended the ketogenic diet to many of my patients trying to fix weight and metabolic issues they haven’t been able to correct for years. One of them mentioned this change to their primary care physician, who was reviewing the statins and several other medications they have this patient on, who reacted with disbelief. Ketosis! How could I recommend such a life threatening intervention?! They were told not to see such a quack like myself any more before they really hurt themselves.

The problem was the physician, and this internet troll, thought I was talking about ketoacidosis. Fortunately, they found a new (and informed) PCP who supported the switch, and they are now off many of the unnecessary medications and improved their health in countless ways.

Ketosis is NOT dangerous because ketosis is NOT the same thing as ketoacidosis.

Surely the most conclusive proof that ketosis and ketoacidosis are not the same thing is that they are, in fact, two different words. To the best of my knowledge, two different words usually have two different meanings.

Why are people confusing these two completely different words? Different words require different definitions, so let’s take a stab at it. 

Is ketosis dangerous? no because ketosis is not ketoacidosis


First, what is ketosis? Good question. Ketosis (or clinically known as nutritional ketosis) is the measurable state of ketone bodies in your bloodstream. In other words, ketosis is using fat as a primary energy source instead of carbohydrates. Ketosis is a perfectly normal state of human metabolism which comes with a wealth of benefits. Without ketosis, you wouldn’t be reading this article because all humans would have died many thousands of years ago.

Ketosis was a prime evolutionary advantage. Without our body’s ability to go into ketosis, we would have been extinct as a species. Without access to carbohydrates for even short stretches of days, instead of starving to death without a constant supply of glucose and glycogen from carbohydrates, our bodies produced ketones from stored fat (and some protein) to provide us with energy to the brain (most importantly), muscle and heart tissues.

Switching from primarily using carbohydrates as fuel to primarily using fat as fuel so that we could survive even short stints without carbohydrates is a great evolutionary advantage in my opinion.

Not only is this is a normal metabolic state, ketosis has also been shown to decrease inflammation, increase fat burning, protect against cancer and neurodegeneration, increase longevity and healthspan, improve immune system, improve cognition, and many other fantastic health benefits.

Alright, ketosis is a normal metabolic state of using fat for a primary fuel source that is really beneficial. So what is ketoacidosis? Fair follow up.


Ketoacidosis (or clinically known as diabetic ketoacidosis, or DKA) is indeed a serious condition and problem that shouldn’t be brushed off as irrelevant.

The clinical “diabetic” modifier here implies this might have something to do with… diabetes. True. When you have Type I diabetes, your body makes little to no insulin. With a lack of insulin, your body thinks you are starving without carbohydrates, so just like the good ol’ hunter-gatherer days, it starts producing ketones from fat. Good move, body.

However, the problem is your body already had enough glucose to go around, is never satiated with the amount of energy it produces due to the lack of insulin, so there is no feedback loop to say when to stop making ketones. You end up having excessive levels of ketone bodies in your blood, up to 15-30 mmol, which starts leading to severe metabolic issues.

And ketoacidosis primarily happens in Type I diabetics, which due to the ridiculous abuse of processed carbohydrates, is as low as 5-10% of diabetics in total.

The reason this affects Type I diabetics primarily versus Type II diabetics is that in Type I diabetes your body makes little to no insulin, whereas in Type II diabetes, your body typically make some insulin, but the main problem is your body doesn’t respond to it like it should. (Note: Some rare cases patients with very late stage Type II diabetes can also produce absolutely no insulin as well.)

If you don’t have Type I diabetes and your body produces even small amounts of insulin, it is actually a physiological impossibility to be in the dangerous state of ketoacidosis. The normal amount of measurable ketones in your blood on nutritional ketosis is about 0.5 – 3.0 (and sometime as high as 5-6) mmol, not even remotely close to the amount you would have in diabetic ketoacidosis. Again, a physiological impossibility.

The main takeaway here is that (nutritional) ketosis and (diabetic) ketoacidosis are NOT the same words, therefore not the same things. One (nutritional ketosis) is a completely normal metabolic state that uses fat as a primary fuel source that can be tremendously helpful for many people and the other (diabetic ketoacidosis) is a dangerous condition that happens to Type I diabetics.

If I asked a waiter what type of meat special they had on the menu, and he responded in disgust asking why the hell I wanted to know what type of feet where on the menu, scolding me because eating feet is a disgusting and dangerous, I would be confused. Because feet and meat sound somewhat alike, but are two completely different things.

The danger is not in ketosis, the danger is in the misinformation that scares people away from a tremendously helpful and safe nutritional tool.

Different words mean different things.