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Alcoholic Ketoacidosis: Symptoms, Causes, and Risks

Alcoholic Ketoacidosis: Symptoms, Causes, and Risks

Alcoholic Ketoacidosis: Symptoms, Causes, and Risks

Alcoholic ketoacidosis is a condition that occurs when you’ve consumed too much alcohol, and haven’t eaten anything or have been vomiting. In other words, it can occur when you drink too much alcohol on an empty stomach. As a result, ketones (acids) build up in the bloodstream, which can be life-threatening without treatment. Today we’re looking into what causes this condition and the risks it poses.  

What Is Alcoholic Ketoacidosis and What Causes it?

Alcoholic ketoacidosis or alcoholic ketosis is usually caused by heavy drinking, which can cause you to vomit or stop eating. For men, heavy drinking is consuming more than 4 drinks a day or more than 14 a week, and for women, it’s consuming more than 3 drinks a day or more than 7 drinks a week.1

If you don’t eat for a day or longer, then your liver will use up the glucose (sugar) it’s stored up to give your cells energy. 

However, when your liver is using all of its stored up glucose to feed it to your cells, and you don’t eat anything to replenish it, your blood sugar levels drop. This extreme drop in blood sugar levels leads to a decrease in insulin production. 

Your cells need insulin to use glucose for energy. Without enough insulin, your body will seek out another way to produce energy: breaking down fat. 

When your fat cells break down, they release ketones, which are a type of acid that provides your cells with some energy. The problem is that high levels of ketones can cause the blood to become too acidic, which can be life-threatening if it’s left untreated. 

Who Is at Risk for Alcoholic Ketoacidosis?

Alcohol ketoacidosis is most common among people who have alcohol use disorders, and drink a lot of alcohol nearly every day or chronically. Alcohol use disorder or alcoholism is a type of addiction in which the person feels a compulsive and persistent urge to drink alcohol despite the repercussions. 

However, alcoholic ketoacidosis can also occur after an episode of binge drinking. This alcohol use refers to the consumption of 4 or more drinks for females and 5 or more drinks for males within two hours.2 

Not all people who binge drink have alcoholism or alcohol use disorder. Even so, people who are addicted to alcohol are more likely to experience alcohol-induced ketoacidosis, especially among people aged 20 to 60 years.

Alcoholic ketoacidosis is also closely linked to malnutrition, which is a common problem among people who engage in chronic alcohol abuse. When someone who is malnourished goes on an episode of binge drinking, abdominal pain, nausea, and vomiting can occur. Infection and other diseases such as pancreatitis can also cause alcoholic ketoacidosis in people with alcoholism. 

Alcoholic Ketoacidosis Symptoms

So what happens to someone when they have alcoholic ketoacidosis? The symptoms of this condition don’t particularly stand out from any other possible health problems, so it can be difficult to diagnose and recognize. 

Generally, common alcohol ketoacidosis symptoms include:
  • Abdominal pain
  • Nausea and/or vomiting
  • Agitation and confusion
  • Decreased alertness
  • Fatigue
  • Slowed movement
  • Reduced coordination
  • Irregular, deep, and rapid breathing (Kussmaul’s sign)
  • Reduced or loss of appetite
  • Dehydration
  • Vertigo and lightheadedness

The symptoms of alcoholic ketoacidosis vary based on how much alcohol the person consumes, as well as the number of ketones in their bloodstream. As mentioned previously, the more alcohol a person drinks in a short period, the more likely they are to experience this reaction. 

If you develop these symptoms, immediately call 9-1-1 or seek medical attention. Alcoholic ketoacidosis is a life-threatening condition that can end tragically if the person doesn’t get help right away.

Why Is Alcoholic Ketosis Dangerous?

Alcoholic ketoacidosis is dangerous for many reasons. In addition to the possible added complication of alcohol withdrawal in people with alcoholism, other possible risks of alcoholic ketoacidosis include:
  • Hypovolemic shock (a condition in which severe blood/fluid loss prevents the heart from pumping enough blood to the body)
  • Heart attack
  • Seizures
  • Delirium tremens (DTs), which produces symptoms like confusion, shaking, shivering, sweating, and irregular heartbeat 
  • Pulmonary edema (a condition caused by excess fluids in the lungs, making breathing more difficult)
  • Kidney failure
  • Death

Despite these dangers, the good news is that alcoholic ketoacidosis is curable if treated early. However, any long-term risks – such as its reoccurrence – depends on the person’s drinking habits. 

People with alcoholism who experience ketoacidosis from their drinking once are more likely to experience it again if they don’t receive alcohol treatment for their disorder. What’s more, other conditions associated with heavy drinking like pancreatitis, gastrointestinal bleeding, and alcohol withdrawal can also increase the risk of alcoholic ketoacidosis.

Alcohol Ketoacidosis Treatment

Treatment for alcoholic ketoacidosis will depend on how severe symptoms are and whether the person has any additional underlying problems. Usually, people are treated in hospitals and emergency rooms for alcoholic ketoacidosis, during which they may be given the following:
  • Intravenous thiamine (vitamin B1)
  • Intravenous dextrose (a type of sugar to increase blood sugar levels)
  • Intravenous fluid (to flush the alcohol out of their system)
  • Replacement of potassium, phosphorus, and magnesium, as needed
  • Treatment for any other conditions the person may have, such as pancreatitis
  • Medication for alcohol withdrawal
  • Medication for nausea

Help for Alcoholism and Alcohol Abuse

You can prevent alcoholic ketoacidosis from occurring by limiting or stopping your alcohol use. If you have an alcohol use disorder, seeking an inpatient or partial hospitalization program for addiction can help you stop drinking.

Chronic drinking can have more repercussions on your health than just alcoholic ketoacidosis. If you or someone you know struggles with alcoholism, our Chicago drug rehab is here to help. 

Call Banyan Treatment Centers today at 888-280-4763 to learn more about our levels of substance abuse treatment. 

Related Reading:
Impact of Alcohol on Mental Health Why Does Alcohol Make Me Angry?

  1. National Institute on Alcohol Abuse and Alcoholism – Drinking Levels Defined
  2. National Institute on Alcohol Abuse and Alcoholism – Understanding Binge Drinking
Alyssa, Director of Digital Marketing
Alyssa, Director of Digital Marketing
Alyssa is the National Director of Digital Marketing and is responsible for a multitude of integrated campaigns and events in the behavioral health and addictions field. All articles have been written by Alyssa and medically reviewed by our Chief Medical Officer, Dr. Darrin Mangiacarne.