Ketoacidosis, Autophagy & Starvation Mode

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Following a Ketogenic Lifestyle can have great benefits but many people – like me – have some anxiety about:

  • Ketoacidosis, which can be very dangerous if you are type I diabetic.
  • Autophagy, which literally means self-eating, but but with Keto it is a healthy natural process.
  • Starvation Mode, which is just a scary thing made up by the diet industry that doesn’t happen if you follow a healthy Keto lifestyle.
Ketoacidosis, Autophagy, Starvation Mode

Scary Words

These horrible sounding ” scare words” have been the bad boogie men of the dieters since we all started getting heavier in the late 1950’s.

I remember hearing 30 years ago that if a person with a lot of body fat were to stop eating they would probably die before they got skinny. FALSE.

Of course this was about the same time that fat-free, uber-sweet foods were all the rage and the lowest fat diets were considered the healthiest.  Remember Snack-Wells?

It never made sense to me that fat is the body’s way of storing energy for lean times ~ but diet gurus said that if you stopped eating you would burn your muscles instead of fat.

I was just a kid though – I mean who was I to question all the low fat diet gurus? All I wanted to do was grow muscles…so I ate the six tiny meals each day that diet gurus recommended.

But the reason it never made sense is that the body doesn’t work that way.

If you have a bunch of body fat to burn and you stop eating (like really stop – zero calories) your body will get into ketosis. Your liver will make ketones out of body fat and burn fat for energy.

If you remove insulin by fasting or avoiding carbs, your body will have to burn fat for energy.

The reason people are afraid of Ketoacidosis, Autophagy and Starvation Mode is due to misinformation and misunderstanding.

My goal with this post is to break it down for you so you can see that with a HEALTHY KETO LIFESTYLE  you should not fear these horrible boogie-men any more.


The healthiest most efficient and least inflammatory state for your body is Ketosis.

Generally, the more time you spend in ketosis the more fat you will burn. This is the whole point of a ketogenic diet.

Ketosis is how your body uses fat for fuel.  It occurs only when the insulin levels in your blood drop to “fasting levels.”

About 2 hours after consuming carbohydrates Insulin will return to fasting levels.

Fasting insulin levels can be maintained by eating a ketogenic diet (nutritional ketosis) or by not consuming any calories (fasting ketosis).

Ketosis is a natural process that occurs in everyone at some point during every day (even sugar burners who eat carbs). If you sleep for more than 2 hours, your body will use stored glycogen for a while.  But energy demands will cause the liver to start making ketones after those are gone.

Ketosis occurs when insulin and blood sugar are very low.

During Ketosis the level of ketones will increase from zero to between 0.5 and 3.0 nM.

Ketosis has great benefits.  That’s why it is the goal of a healthy Keto Lifestyle.

Ketosis Takeaway:

Ketosis is the goal of the Keto Lifestyle.  It is a healthy natural process by which your body burns fat.


When I first started Keto I was afraid of ketoacidosis.  So I started checking it out online, I was shocked at by all the crazy stuff I found.

There was one blog that claimed that Ketosis (the healthy condition) is actual a mild form of ketoacidosis (a dangerous condition that can kill you).

Ketosis IS NOT a mild form of ketoacidosis.

Ketoacidosis occurs when a person has no (or very low) insulin levels, extremely high blood sugar, and blood ketone levels above 10 nM. (3 to 20 time higher than healthy ketosis)

This combination of no insulin and extremely high blood sugar and ketones lowers the Ph of blood making it acidic.

Depending on how acidic the blood gets and how long it stays that way, this causes damage on a cellular level and if the person does not get some insulin it can cause death.

Sounds really scary right, but here’s the good news, unless you are a type I diabetic, or an advanced alcoholic you really shouldn’t worry about ketoacidosis. You’d be more likely to get hit by lightning.

Really the only way that you can get the combination of high blood sugar, no insulin and high ketones is if your pancreas is not producing any insulin at all.

Ketoacidosis Takeaway:

While quite dangerous, ketoacidosis is also extremely rare.  It occurs in type I diabetics and advanced alcoholics and in the rest of the population is so rare as to be non-existent.


AKA self cannibalism & self-eating can actually really good for you. I know – hard to believe – but let me explain.

The human body is an amazing machine.  It has evolved to take care of itself through the good times and the lean times.

Our modern problem is that we have no lean times.

Good Autophagy

You know that your body needs protein.  I am sure that you also know that dead and diseased cells in your body need be dealt with in some manner.

Did you know skin cells are changed every 27 days.  Skin cells die.

Muscle cells die, and are replaced by new ones.  Bones and most organs are the same.

This is a beautiful process.  What happens to all those dead and dying cells that are no longer of any particular use, is that your body reabsorbs them breaks them down and recycles the protein.

Under the conditions that we were evolved for, this is a fantastically healthy process. 

Not only does it rid the body of disease and toxins, but the recycling protein can help maintain our muscles bones and organs in lean times.

Autophagy is also how your body combats things like cancer.

Bad Autophagy

The Standard American Diet (SAD) can be a bit of a problem for the autophagy process because we have such abundance of protein in our diet that we never really need the recycled protein from autophagy.

This can create a build-up of diseased cells which – along with over consumption of processed carbs – creates an environment that is conducive to the growth of cancer. (I admit this is an over simplification but it is basically how it works.)

Really Bad Autophagy

The high frequency, high carb, low fat, low calorie diets can create a bad situation. Even though you have body fat that you could burn, burning that fat is blocked by the insulin that is secreted in response to frequently eating carbs.

On this kind of low-fat-high-carb-low-calorie diet, your body still needs energy.  There isn’t enough energy from the carbs because of the low calories and you can’t burn fat because of the insulin. 

So your body will “self-eat” the protein out of your joints, bones and muscles to use for energy. YIKES! Read that again.

This also has the affect of reducing your base metabolic rate so that you end up burning less calories.

Be careful of these diets like the ones promoted by the Jillian Michaels, the Biggest Loser, and most of the weight loss industry for the past 50 years. 

Autophagy Takeaway:

Autophagy in the context of a healthy Keto diet is really good for you.  But autophagy combined with a low fat diet can be really bad for your health.

What happens When you stop eating.

Starvation Mode

Starvation is when your body is unable to access the energy it needs to fuel you bodily processes.

Starvation mode is the idea that if you restrict calories your body is going to adjust by slowing down your metabolism and going into “starvation mode” to conserve energy. 

The result, according to this view, is that you will be starving, but you won’t lose weight because your body is conserving energy.

You will lack energy and be cold, and have weakening muscles and diminishing muscle mass.

This is a scare tactic that I believe was made up by the weight loss industry. 

Is Starvation Mode a Real Thing? 

It can be, as I explained above, a low-fat-high-carb-low-calorie diet could fail to supply adequate energy while locking you out of burning your body fat

But if you’re restricting calories in the way that the human body is designed, of course you will burn fat before you enter “starvation mode.”

I’m sure that if you restrict calories as in the way explained in the”Bad Autophagy” section above, you will have some “starvation mode” problems.

People don’t like to diet because they feel hungry all the time. I think What these people want is a reason to go on a diet that is prepackaged by some diet guru. They think it will be easier or more effective if they have to pay a lot for it.

The fact is that if you eat a calorie restricted, low fat, high carb diet you can be gaining fat and literally starving at the same time. 

There is fantastic explanation of this in Gary Taubes book Why We Get Fat and What To Do About It.

He talks about a third world country where over-weight mothers bring malnourished children into a doctor’s office.  The over-weight Mom is not eating all of the food, but she is just as malnourished as the child. Because she (the Mom) gets most of her calories from carbs,  and she cannot access her own body fat for fuel.

Starvation Mode Takeaway: 

If you restrict calories as a part of a healthy ketogenic diet or you do intermittent fasting  you won’t experience anything like “starvation mode.” 

On the other hand if you eat carbs, and eat them frequently your body can switch into “Starvation Mode.”

The Overall Takeaway

Ketoacidosis, and Starvation Mode are not scary and not a problem at all if you follow a healthy Ketogenic Lifestyle. 

And, Autophagy is actually healthy. It is cleaning out all of the diseased and dying cells, and using the protein to maintain your muscles.

If you wonder if you are actually in Ketosis, check out these 9 Sure signs that you are doing it right.

Don’t Be Afraid, Be Healthy and Keto On,

Thom Collins

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  1. Acidosis is different than Ketosis. I didn’t realize the difference and have been avoiding Keto because of this very issue. I appreciate your take and look forward to getting to know you guys.

  2. 5 stars
    Thanks man! This article helped me understand a lot more about Ketosis and I’ll be better armed when my very concerned family has questions. Happy New Year to me!!!!