Ketones and Intensive Care

For two years now I’ve been bitching about using exogenous ketones at hospitals, notably at the intensive care unit. I haven’t seen or heard of any changes, research or contemplation in this direction. So far my pondering was limited to Facebook. Now I’m publishing on a public forum, this blog, so that everyone can read it and join the discussion.

I’m not a complete stranger to hospitals, albeit not due to personal injury or illness. I visited family there. I trained there in function of my EMT license. I delivered patients during Red Cross activities. All in all, I’ve seen a bit of it. Yet, I’m not an emergency doctor or nurse. So let’s not get carried away here.

Let’s reiterate. My idea is to use exogenous ketones instead of/in combination with glucose as a fuel source for patients. Glucose is already administered as a source of fuel for the body. Why aren’t ketones? Someone, please explain it to me. Justify it. But wait a minute. Why am I suggesting this? Well, how long should I make this post? My intention isn’t to write a long essay with sources. It is to throw the idea out there and see if we can take this somewhere. Therefor, let’s go through it very briefly.

I wasn’t getting the result that were promised to me with the food pyramid and exercise. I came across low carbohydrate diets, notably the Paleo/paleolithic diet variety. At least for me, this low carb/high fat approach seemed to cut mustard. No longer content with reading general/mainstream books I started looking towards specifics, whether it be books or research papers didn’t matter. So, what did I find out?

Nature, and with it biology, is wonderfully complex. Despite this enormous challenge, many a researcher has succeeded in peeling away some of the inner workings. Where to look for current knowledge on energy production in the body? A biochemistry book. As it turns out, there’s a molecule in our body that has lots of energy. We use it for example to move our muscles. It’s called adenosine triphosphate, or ATP. We make it in our cells. Depending on the source and the pathway in the cell, we make more or less of it. If glucose (think carbohydrates) is the starting point then it is possible to get 36 ATPs. If palmitate (think fats) is the starting point, it is possible to get 106 ATPs. More is better. Hmm, there’s something about these fats. What else happens when fat metabolism is humming? We start to produce ketone bodies. Tissues such as the heart muscle and kidney cortex prefer these to glucose as a source of energy. So, do we need to consider ketones as a source of fuel in hospitals? I believe so.

What are complications? For one, most people are carbohydrate burners and don’t have a good fat metabolism. When faced with the extra burden of trauma and/or illness, it may be detrimental to forcefully switch to fat metabolism while at an intensive care unit. When taking ketones, does the body amp up fat metabolism? I don’t know. Maybe when combining glucose and ketones the cells still hum with glucose metabolism and the ketones are taken up by tissues for fuel, in a sort of double fueling system. Is this being done? Is research ongoing? Just a thought. Let’s discuss this.