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Keto Diet Basics

Is It Ketosis? Read These 10 Signs of Ketosis to Find Out

Published on: May 24, 2018

Is It Ketosis? Read These 10 Signs of Ketosis to Find Out

The ketogenic diet will make you feel like a new person once you’re fully keto-adapted. To be keto adapted means your body is effectively using fat for fuel and that your cells are running on ketones. This metabolic switch is scientifically proven to come with a host of health benefits like weight loss, sustained energy, and cancer prevention.

But before becoming keto-adapted, you first need to enter the metabolic state of ketosis. Being in ketosis means you're on the right path to weight loss and greater well-being. But how do you know you've reached this ketogenic milestone?

10 Most Common Ketosis Symptoms

Well, you look for hints. Ketosis causes a range of changes inside your body, all of which lead to specific signs and symptoms. We've covered 10 of these signs of ketosis and explained why each one happens and what to do about the more uncomfortable ones.

1. Keto Breath

keto breath - ketosis symptoms

One of the first noticeable signs of ketosis is keto breath. Keto dieters describe it as fruity-smelling or resembling the smell of nail polish remover. Keto breath is also quite strong, persistent, and unpleasant for everyone around you. Luckily, it goes away after some time of being on the diet.

Bad breath is a good sign you're in ketosis. Your body makes three types of ketones on a ketogenic diet.

  • Acetoacetate
  • Beta-hydroxybutyrate (BHB)
  • Acetone

Of these three, acetone is a byproduct of the other two and is a volatile compound. Your body gets rid of acetone mainly through the lungs and urine [1]. This means that bad breath from ketosis is not a sign of bad hygiene. It's really nothing to worry about and is even one of the more reliable signs of ketosis.

What to do:

Chewing sugar-free gum can help mask keto breath. Brushing your teeth, flossing, and mouthwashes can also keep your breath fresh and keto breath less noticeable.

2. Weight Loss

If you notice the number on the scale drop in the first week of a keto diet, don't get too excited. What you are actually losing is water weight. Rapid weight loss is a sure sign your body is switching into ketosis. However, it may not be the best thing.

Losing water in the first weeks of a keto diet is the result of two things:

  1. Glycogen depletion
  2. Electrolyte imbalances

Your body stores glucose in the form of glycogen in your liver and muscles. When you reduce your carb intake, your body turns to stored glycogen. With the depletion of glycogen stores, you also end up losing lots of water because glycogen molecules are three to four parts water [2].

Your kidneys work overtime to flush out this extra water. The big downside to this is that with that water, you also lose electrolytes. Electrolytes are minerals like sodium, potassium, magnesium, and calcium and that balance out your body's hydration, heart rhythm, and muscle functioning among other things.

What to do:

Drink electrolyte-rich water in the first week of a ketogenic diet to rehydrate and replenish. Losing electrolytes leads to a wide range of side effects that we discuss in detail below.

3. Fatigue

fatigue, one of the signs of ketosis

Fatigue is a common symptom of the keto flu. And if you haven't heard of the keto flu, it’s a range of flu-like symports people experience in the first week of a keto diet. To learn more about the keto flu, read our article here.

The keto flu is largely a direct result of electrolyte imbalances that you can experience early in ketosis. Fatigue is a prominent feature of the keto flu and can be extreme. You may find it difficult to complete simple tasks.

Fatigue is also a result of your body making the metabolic switch into ketosis. Ketosis can be taxing on the body as it requires massive changes to take place. Luckily, this fatigue is only short-term. You'll start feeling much more energetic in the weeks to come.

What to do:

Drinking water with a bit of salt or taking bone broth can help replenish your electrolyte levels. You should also drink coconut water as studies show it's as effective as sports drinks in replenishing electrolytes [3]. One cup of coconut water contains 6.3 grams of net carbs, so keep that in mind as well.

4. Thirst

With all that water being flushed out of your system, you'll also feel thirsty. Loss of electrolytes can also make you drink more water than usual. The frequent trips to the bathroom can be annoying, so you may get tempted to drink less to reduce your bathroom visits.

Don't think that drinking less to avoid frequent urination is a good thing. You absolutely must drink more to feel better and avoid dehydration. Electrolyte imbalances can also be dangerous, so it's important to keep your electrolytes in check.

What to do:

Add Himalayan salt to your meals. Just like table salt, Himalayan salt is also mostly sodium. However, it also contains a bit of potassium, magnesium, and calcium to help with meeting electrolyte needs. You can also increase your carb intake slightly to help your body retain some water. Still, do keep your intake below 30 grams of net carbs per day to stay in ketosis.

5. Ketones in Urine

One of the most reliable signs of ketosis is having ketones in urine. But how do you tell there are ketones in your urine? You take a urine test strip of course! Our Ketone Urine Test Strips are super affordable and easy to use. They'll tell you if you're in ketosis in under a minute.

Your body flushes out ketones in the first few weeks of a ketogenic diet. But as you continue dieting, your body will start using ketones more effectively and fewer end up being flushed out of your system [4]. This means that ketone urine test strips won't tell you how many ketones your body is making. Nonetheless, ketones in urine in the first weeks of going keto is a good sign of ketosis, so go ahead and test yourself.

What to do:

There's nothing wrong with having ketones in urine on a ketogenic diet. So, no remedies needed here. If you want to reduce the levels of ketones to become keto-adapted, then boosting your fat intake is the way to go.

6. Ketones in Blood

Having elevated blood levels of ketones is another sign of ketosis. To test for ketones in the blood, there are special devices called ketone meters. These devices show circulating BHB and are considered the most reliable for measuring ketosis. BHB is the ketone your body is utilizing the most.

Although having ketones in your blood is one of those signs of ketosis you can trust, measuring it constantly is a waste of time and money. Elevated ketones are not always a sign your body is keto-adapted and being keto-adapted is the whole point of a ketogenic diet.

Besides, studies show that breath acetone correlates with the levels of ketones in the blood [5]. A cheap ketone breathalyzer will also tell you whether you're in ketosis or not. It's also less invasive than taking daily blood tests.

What to do:

Blood ketone levels go down on their own when you become keto-adapted. Your body will start utilizing fat to fuel your muscles, and the ketones it is making to fuel the brain. Fewer ketones are needed for keto-adaptation.

7. Appetite Suppression

You'll notice your appetite drop significantly once you go keto. Drops in appetite are one of the more apparent signs of ketosis, and that keto dieters accept wholeheartedly. There are several reasons why ketosis can make you want to eat less:

  • Higher fat intake
  • Rising ketones
  • Low blood sugar

Fat contains double the calories of both protein and carbs. This makes it a highly satiating ingredient. Your body also digests fat slower than other nutrients which contribute to appetite suppression.

Studies show that being in ketosis (having elevated ketones) also changes your hunger hormone levels [6]. More specifically, ketosis suppresses ghrelin (the hunger hormone) release.

A drop in circulating blood glucose also affects your hunger hormones. Sharp rises and drops in blood glucose wreak havoc on these hormones. Bot once blood glucose becomes stable, you can expect to gain more control over your hunger levels.

What to do:

If weight loss is your goal, embrace this new change in your appetite. Otherwise, wait a few weeks for your body to adapt to this new way of eating. With time, your body will develop the enzymes needed to digest fat and you'll be able to eat more to maintain your current weight.

8. Digestive Issues

Constipation, diarrhea, and stomach pain are also signs of ketosis. They're definitely one of the more uncomfortable signs of ketosis but luckily, they won't last forever. These symptoms are partially due to electrolyte imbalances and partially due to the sudden change in macronutrient ratios.

Electrolyte imbalances cause dehydration as already explained. Dehydration, in turn, causes stomach pain [7]. However, more common issues that keto dieters face are constipation and diarrhea. Both happen because you cut back on carbs and eat more fat than your body is used to.

If constipation is your main issue, then too little fiber and water could be the problem. Fiber helps things run smoothly in your digestive system, and it also keeps your gut healthy by keeping good bacteria numbers optimal. Low fiber intake can also lead to diarrhea in some people, and especially when combined with a high-fat diet.

What to do:

Boost your fiber intake and go slowly on the fat. Your body needs time to develop enough fat-digesting enzymes. It also needs enough fiber on a low-carb diet to prevent the growth of bad gut bacteria.

9. Insomnia

Many keto diets claim they lose sleep when first entering ketosis. The evidence that ketosis leads to insomnia is mostly anecdotal. In other words, there are currently no studies proving that ketosis can lead to insomnia. Most studies, in fact, show that keto diets actually improve sleep quality [8, 9].

Nevertheless, a quick search through keto discussion threads and you'll see many keto dieters experience sleep problems as one of their signs of ketosis. This change most likely has to do with digestive issues and electrolyte imbalances. Changes in gut flora can also affect the levels of certain neurotransmitters in the brain.

Ketosis also increases energy at some point, which may make you feel restless initially. Also, a higher intake of caffeine can disrupt your sleep. Many keto dieters use coffee to boost their energy while first starting keto. We don't recommend doing that.

What to do:

Drink a bit of coffee in the morning and avoid anything with caffeine throughout the day. Have a brisk walk in the afternoon or before bedtime. Also, take probiotics and fiber to improve gut health which studies show promotes quality sleep [10].

10. Increased Energy

While fatigue and low-energy are one of the first signs of ketosis, a sudden boost in energy often follows it. Ketone bodies and fat are a much more efficient fuel source than carbohydrates. They also improve mitochondria functioning according to one study examining the effect ketones have on mitochondrial disorders [11].

Ketone bodies also offer sustained energy. All cells in your body that have mitochondria can thrive on ketones. Ketones don't require insulin for your cells to use them which also makes them energy-efficient. You won't experience draining fluctuations in blood glucose and insulin which further contributes to greater energy levels when you're in ketosis.

What to do:

Having more energy in the first days of ketosis is definitely one of those signs of ketosis we appreciate. It can, however, make you restless at times. Meditate and relax to keep yourself calm when your energy levels get sky high.


The ketogenic diet definitely comes with a whole lot of benefits. From fast weight loss and diabetes control to greater energy and mental sharpness, there's so much a keto diet can offer. However, you need to deal with some uncomfortable signs of ketosis before you can reap all of those great keto benefits.

Experiencing some of the above signs of ketosis has its positive sides too: they indicate that your diet is working. If you ever wondered whether you're in ketosis and your efforts are paying off, look for these 10 signs of ketosis to know for sure.

Most are simply a result of your body trying to adapt to the keto diet and rising ketone levels. Others are a result of electrolyte imbalances or dehydration. Make sure to stay well-hydrated and well-fed to feel better while you're just starting on a keto diet. Also, read our article on ketosis troubleshooting here.


  1. Musa-Veloso K et al. Breath acetone is a reliable indicator of ketosis in adults consuming ketogenic meals. 2002 July -
  2. Kreitzman SN et al. Glycogen storage: illusions of easy weight loss, excessive weight regain, and distortions in estimates of body composition.... View all references

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