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Are You on the Ketogenic Diet? Here Are the Signs of Ketosis

Medically reviewed by Regina Victoria Boyles, MD · Pediatrics

Written by Lorraine Bunag, R.N. · Updated May 10, 2022

Are You on the Ketogenic Diet? Here Are the Signs of Ketosis

The ketogenic diet, an eating regimen requiring the person to consume high fat, moderate protein, and very little carbohydrate¹, has been deemed effective by many people. However, dieters believe that for you to lose weight, you must first reach the state of ketosis. What exactly is ketosis, and what signs of ketosis should you watch out for?

What Is Ketosis?

Nutritional ketosis is a state the body reaches when it burns fat for energy instead of carbohydrates. While it is mostly associated with the ketogenic diet, please note that you can likewise reach ketosis through other diets, such as a low-carb diet and intermittent fasting, as they also restrict your carb consumption.

In a state of ketosis, the body has increased ketones, substances we use as fuel or energy. Excess ketones (not used as energy) will be excreted via the kidneys through urine.

What Are the Signs of Ketosis?

Even before losing weight, you might be able to determine if the ketogenic diet is working by watching out for the following signs of ketosis:

1. Bad Breath

Many people who found the ketogenic diet effective experienced bad breath, particularly a strange fruity breath.

Ketosis-related bad breath occurs mainly due to acetone, a kind of ketone released in the urine and breath.

According to one report, “breath acetone is as good a predictor of ketosis.”²

Note there are available breath meters or analyzers in the market. They can measure the amount of ketones in the breath.  

2. Increased Thirst

Do you suddenly feel like you’re not getting enough water? If that’s the case, then it might be one of the signs of ketosis.

One report involving cyclists identified dehydration as one of the side effects of ketosis. The investigators also noted that the athletes had a higher risk of developing kidney stones, a known complication of dehydration³.

3. Fatigue or Weakness

A lot of people associate a ketogenic diet with increased energy. However, before that happens, dieters almost always experience fatigue first. For this reason, people also consider it as one of the signs of ketosis.

The weakness or fatigue happens as the body switches from using carbs to fat. You see, carbohydrates give a quicker burst of energy.

One study discovered that one of the side effects of ketosis diet is tiredness; the participants experienced it in the first few weeks⁴.

4. Increased Ketones in Blood and Urine

Finally, if you suspect ketosis, you can go to the doctor so they can check your blood and urine for ketones.

There are also available home kits for this: the one for blood looks like a glucometer, while the one for urine uses dip sticks.

Are There Dangers to Ketosis?

Reports say achieving regular nutritional ketosis is beneficial not just for weight loss, but also for blood glucose control (especially for people with diabetes), epilepsy, and overall metabolic health⁵

But are there dangers to achieving ketosis?

Ketosis is generally safe for most people, especially when doing it under their doctor’s recommendations. However, side effects are common.

For instance, dehydration may lead to other problems, such as muscle cramps and headaches. Fatigue or tiredness may also lead to poor school or work performance.

To reduce the possibility of side effects, experts recommend drinking plenty of water, getting adequate fiber, and avoiding intense workouts. They also suggest going on a low-carb diet first before diving into the ketogenic diet.

Key Takeaways

The ketogenic diet focuses on high fat, moderate protein, and little carb intake. As the body switches from using carbs to burning fats, you enter the state of ketosis. Some of the signs of ketosis include bad breath, increased thirst, fatigue and tiredness, and increased ketones in the blood or urine.
Generally, achieving ketosis is safe for most people. But to be on the safe side, consult your doctor first if you plan on doing the ketogenic diet.

Learn more about Healthy Eating here


Hello Health Group does not provide medical advice, diagnosis or treatment.

Medically reviewed by

Regina Victoria Boyles, MD


Written by Lorraine Bunag, R.N. · Updated May 10, 2022

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