The most serious possible complication of starvation ketosis is a state called metabolic acidosis, where the pH level of the blood drops to a dangerous level. This can lead to a cascading series of problems, potentially resulting in death if issues are not addressed. Patients can also experience complications associated with poor nutrition and nutrient deprivation which may exacerbate the situation. Treating starvation ketosis requires carefully supporting the patient nutritionally and rebuilding the diet for recovery.
As people stop eating, for whatever reason, their bodies turn to stored sources of energy for fuel. In particular, the liver starts burning fat, creating ketones as a byproduct. In the early phases of ketosis, patients may notice a fruity smell on their breath, indicating the rising levels of ketones, which the body tries to eliminate through the lungs. As the ketosis progresses, the blood can start to become acidic.
Organ damage can occur, because the body is used to operating with a stable acid-base balance. In addition, the brain may start to swell, which can lead to coma. If the patient does not receive treatment, these complications can lead to death as the organs shut down and the patient loses brain function. Patients can also experience long-term health problems after surviving starvation ketosis, like impaired liver and kidney function or brain damage, if they didn’t receive treatment early enough.
As patients starve, they can notice side effects like fatigue, extreme cold, blurred thinking, and impaired coordination. These are all complications of ketosis, related to the body’s decision to burn fat stores for energy. As the condition affects the brain, cognitive function can decline and the patient may experience difficulty with even basic tasks, ranging from understanding conversation to walking steadily. Eventually, the patient will become unconscious and slip into a coma, indicating the development of severe complications.
In cases where starvation ketosis is suspected because of the patient’s known history or circumstances, a medical team can develop a plan for treating it. Patients cannot simply be given high volumes of food or intravenous drips of nutrients all at once, because these could also cause complications. Instead, they typically need constant monitoring and careful treatment to stabilize the acid-base balance, provide the body with glucose for energy, and address issues like organ damage. Once the patient is stable, medical providers can determine if additional intervention and treatment are necessary; for example, a child with the condition may need to be removed from an unsafe home.