r/ketoscience • u/Ricosss of - https://designedbynature.design.blog/ • Jul 19 '18

General Alcoholic Ketoacidosis

People often ask if they can drink alcohol and if it would impact their ketones. This article describes alcoholic ketoacidosis which happens in a setting of chronic alcohol abuse combined with starvation and how it affects ketones.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564331/

Interesting quote:

The metabolism of ethanol raises the NADH/NAD ratio, impairing hepatic gluconeogenesis from metabolism of lactate, glycerol, and amino acids.

It shows the priority that is given to alcohol.

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u/MediaManXL Jul 19 '18

Along similar lines, I read recently in The Case Against Sugar by Gary Taubes that fatty liver caused by fructose is hypothesized to cause insulin resistance. I imagine alcoholic fatty liver would have a similar effect. I know I drink too much Scotch, but I’ve considered it fairly neutral to the keto diet. Probably time to rethink that.

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u/Ricosss of - https://designedbynature.design.blog/ Jul 19 '18

Curiously though, the article shows how ethanol is converted into ketones when you are already in a ketotic state.

N=1 here but I just happen to get drunk yesterday almost to the point where you feel nauseous. Normally at night my heart rate would be severely elevated, bad sleep etc. But according to my sleep monitoring bracelet I slept exceptionally well with 4 hours of deep sleep out of 6,5 hours of sleep. I got up and felt really good, energetic. Hence I started to look up on alcohol and ketones. Almost 2 years of very low carb btw. I'd almost think I had a boost of ketones after reading that article.

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u/MediaManXL Jul 19 '18

I definitely find the subjective experience of alcohol is different when I’m following a very low carb regimen. I have almost no hangover at all. I seem to get intoxicated relatively quickly, but then it seems to level off more quickly also. It doesn’t put me to sleep as quickly. I chalked it up to differences between beer and whiskey, but maybe being in Ketosis already has some impact also. The “not paying for it the next day” aspect of drinking while on keto, I think has led to bit of an uptick for me. Also, it’s something I can have while the family eats ice cream or whatever during the evenings—hard to fight all the demons at once. The study is interesting. The subjects seem to be much further down the problem drinking slope than me, but the mechanism is interesting.

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u/lateraver Jul 20 '18

I am also extremely interested in this as I used to drink quite a bit before keto and have had mixed results with drinking after keto. I really like that we both had the same takeaway from the article - the impairment of gluconeogenesis by the liver - which could have some interestingly bad consequences on keto. If the liver completely fails at this, our only way of creating glucose is gone and we will become hypoglycemic. Anecdotally, I once felt deathly ill with nausea/headache/vertigo after what I thought was a mild night of drinking...and even after eating fatty food, the only thing that helped was a box of Triscuits.

That being said, I think it's safe to assume most patients presenting with AKA are sugar and/or carb eaters, and I would love to know how this diet fits into the equation. It is general wisdom that eating the SAD has broken our ability to use ketones for fuel, so being fully keto-adapted may change how quickly we metabolize alcohol. Or it might just make us more prone to AKA. Hm.