Momentum in the Mountains 2024


When Are Ketones Dangerous

author avatar Dr. Eric Berg 07/01/2024

There’s a lot of buzz around the ketogenic diet these days and for good reason. It can be a powerful tool to achieve weight loss, gain control over your blood sugar levels, and feel more energized.

As you know, the keto diet involves drastically reducing carbohydrates and replacing them with healthy fats. This shift forces your body to enter a metabolic state called ketosis, where it begins to burn fat for fuel instead of glucose.

A natural byproduct of this fat-burning process is the production of ketones. But as with many aspects of health and nutrition, there can be too much of a good thing.

While ketones themselves are beneficial, reaching excessively high levels can be a cause for concern. This leads us to an important question: when do ketones reach a dangerous level and become a real issue?

Let's explore this concern, separating fact from fiction and understanding when you actually need to worry about the dangers of high ketone levels.

Understanding Ketones Danger Level

For most individuals embarking on a ketogenic journey, the presence of ketones in the bloodstream signifies their body is efficiently utilizing fat as fuel. A blood test can check your blood ketone levels to determine if you are in ketosis.

Ketone levels typically range between 0.5 mmol/L to 3.0 mmol/L in healthy individuals following a ketogenic diet.

This range often indicates that you are successfully achieving ketosis, and your body is adapting to burning fat for energy. You might experience heightened energy levels, improved mental clarity, and steady weight loss.

These ketone levels are generally considered safe and beneficial.

When Do Ketones Become a Concern?

While ketones are generally safe, exceptionally high levels, usually exceeding 10 mmol/L can signal a potential problem known as ketoacidosis.

Ketoacidosis is a serious metabolic state most commonly observed in individuals with Type 1 Diabetes, a condition where the pancreas fails to produce insulin.

Without enough insulin, the body can't utilize glucose for energy effectively. It leads to an overproduction of ketones, overwhelming the body’s ability to regulate their levels.

This excessive ketone buildup disrupts the body's pH balance, making the blood dangerously acidic. This is when high ketone levels become a real health concern requiring immediate medical attention.

High Ketone Levels: Distinguishing Ketosis from Ketoacidosis

It's important to emphasize that nutritional ketosis experienced by healthy individuals following a well-formulated keto diet is distinctly different from ketoacidosis.

Nutritional ketosis involves a controlled and moderate elevation of ketones, serving as an alternative energy source. This state doesn’t typically pose a threat to individuals without pre-existing conditions like Type 1 Diabetes.

However, ketoacidosis is a severe metabolic imbalance resulting from insufficient insulin levels, predominantly occurring in individuals with Type 1 Diabetes.

Factors Influencing High Ketone Levels

While anyone following a ketogenic diet will experience an increase in ketones, certain factors can impact those levels. Understanding how these factors impact ketone production empowers individuals to manage their levels more effectively.

Fasting Duration

As your body depletes its glucose reserves, it turns to fat stores for fuel. The longer you fast, the more ketones your body will produce.

It is worth noting that extending fasting periods beyond three days may lead to the breakdown of muscle mass as the body seeks alternative sources of fuel.

Athletic couple doing stretching exercises

Exercise Intensity

While moderate exercise is beneficial during ketosis, engaging in high-intensity workouts while significantly restricting carbohydrates can elevate ketone levels.

Listen to your body's signals and adjust exercise routines when needed, ensuring you are consuming enough electrolytes to maintain proper hydration.

Protein Consumption

While protein is crucial in the diet, excessive protein consumption can contribute to higher ketone levels. Through a process called gluconeogenesis, your body can convert protein into glucose for energy.

This conversion becomes particularly relevant when glycogen stores are depleted, such as during prolonged fasting or very low-carb diets.

While moderate protein intake won't hinder ketosis, exceeding your body's needs might. Aim to include a moderate amount of protein with every meal.

Individual Metabolism

Our metabolic rates are unique and play a significant role in ketone production. Certain individuals naturally produce higher ketones than others. Factors influencing metabolic rate include genetics, body composition, activity levels, and hormonal variations.

If you have any underlying health conditions, especially involving the pancreas or insulin production, working closely with a healthcare provider or registered dietitian to monitor your ketones is essential.

Signs of High Ketone Levels to Monitor

Ketoacidosis, characterized by dangerously high ketones, often exceeding 10 mmol/L, demands immediate medical attention. It is an acute complication of diabetes that develops when the body produces high levels of blood acids called ketones.

Ketoacidosis develops when your body cannot produce enough insulin. Below are several symptoms that might indicate critically high ketone levels, usually in the context of uncontrolled diabetes.

  • Persistent fatigue and weakness

  • Frequent urination, especially at night

  • Excessive thirst and dry mouth

  • Nausea and vomiting

  • Fruity-smelling breath

  • Confusion or difficulty concentrating

  • Shortness of breath

  • Abdominal pain

If you are experiencing any of the above symptoms of high ketone levels you should seek immediate medical attention.

You may need to test for ketones using urine test strips at home if you are experiencing these symptoms, but it is best to be seen by a medical professional.

Managing High Ketone Levels

For individuals without diabetes, maintaining a healthy ketone level is generally achievable through a balanced approach. These strategies can support your body’s transition to ketosis while minimizing any risk associated with elevated ketone levels.

  • Stay well hydrated: Sip water consistently throughout the day. Incorporate electrolyte-rich beverages when needed. Signs of dehydration, like headaches or fatigue, can indicate a need for increased fluids.

  • Start slowly with carbohydrate reduction: Instead of eliminating carbohydrates abruptly, ease into it to allow your body to acclimate. As your metabolism adapts, gradually reduce carbs to your desired intake level. This method can help prevent dramatic fluctuations in your ketone levels, making the transition smoother.

  • Prioritize electrolyte intake: Pay attention to your sodium, potassium, and magnesium levels as electrolytes play a critical role in regulating fluid balance and overall metabolic function. Adequate electrolyte intake helps mitigate some of the common side effects of transitioning into ketosis like the “keto flu”.

  • Incorporate moderate exercise: Regular physical activity supports healthy metabolic function, improves insulin sensitivity, and helps maintain a healthy weight. However, strenuous activity, especially when not accustomed to it, can increase ketones, so start slowly and gradually increase intensity.

  • Work with a healthcare provider: Regular monitoring, especially if you are new to the ketogenic diet, have underlying health concerns, or are experiencing unusual symptoms, can provide personalized guidance and peace of mind as you navigate your keto journey.

Steak and eggs

Ketone ​Caution

Highlight the importance of monitoring ketone levels while on a ketogenic diet to avoid potential health risks such as ketoacidosis, particularly for those with underlying health conditions.

Maintaining a proper diet with nutritious options like steak and eggs can help manage ketone levels effectively. This protein-rich meal supports muscle maintenance and provides essential nutrients without spiking blood sugar, making it a staple for keto followers.

By understanding the dangers of excessive ketones and incorporating balanced meals like steak and eggs, individuals can safely reap the benefits of the ketogenic lifestyle.


Understanding ketones and when they reach a dangerous level is a crucial part of safely and effectively utilizing the ketogenic diet to your advantage.

Remember, achieving optimal health isn’t about completely avoiding ketones but rather staying within a safe and manageable range.

Armed with the right information, you can leverage ketosis as a powerful metabolic tool, keeping your ketone levels within a healthy range, without causing harm.

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