Ketosis and ketoacidosis are not the same thing.
Ketosis is a 100% natural state, under full control by the body. It can be caused by a low-carb diet or by a brief period of fasting.
Most people who eat a strict low-carb ketogenic diet never reach levels higher than 3 millimolar or so. But ketoacidosis occurs at levels of 10+, most commonly 15+.
Ketoacidosis is a condition where the levels of ketones in the body are abnormally high, poisoning the body. It is a serious and dangerous condition that can quickly develop, sometimes within the space of 24 hours.
There are several different potential triggers for ketoacidosis. It is most commonly caused by illnesses that lead to the production of higher levels of hormones that work against insulin.
High levels of ketones in the urine and high blood sugar levels (hyperglycemia) are signs of ketoacidosis and can be detected with kits in the home.
Ketosis may cause bad breath. Ketones are broken down for use as a fuel source, and acetone is one of the byproducts that is excreted from the body in the urine and breath. This may smell fruity, but not in a good way.
While early symptoms of ketoacidosis include:
- abdominal pain
- confusion and difficulty concentrating
- dry or flushed skin
- excessive thirst and dry mouth
- fruity breath
- frequent urination
- nausea and vomiting
- shortness of breath or rapid breathing
Therefore, ketosis generally isn’t dangerous. It’s usually related to a planned low-carbohydrate diet or a transient condition related to diet only!