8mmol reading on 3rd day of Keto diet

(Jordan Sprott) #1

Hi there, I’m brand new to Keto. I never tested my urine before I started, but tested it today after 3 days and was showing as 8mmol, where i expected to be 1-2. Is this normal or a sign of some kind of issue?

Any help would be appreciated!

#2

Hi and welcome!
I don’t have much experience with the strips, but I’m pretty sure that they’re not very accurate in terms of the millimolars. Also, when you’re first in ketosis your levels will tend to be quite high because you’re making more ketones than your mitochondria know how to use - so what’s showing up in the urine is the extra that you’re not using.
Others will probably be on soon to give you more detailed advice.

(You've tried everything else; why not try bacon?) #3

I would tend to assume that the strip that gave you that reading was badly calibrated, but 8.0 mmol is not wildly dangerous. Unless you are a Type I diabetic, or a Type II in the end stage of the disease with no β cells left, you don’t have to worry about ketoacidosis. The warning is so stern, and it sets the danger level so low, because they want Type I’s to have time to get to the hospital and give the doctors time to get them out of ketoacidosis before it does them in.

At this early stage of the game, your liver is making extra ketones and the kidneys are spilling them into the urine, so reading that high, while unusual, is not completely unexpected. As you go along, you will typically find that there is less acetoacetate in your urine, partly because you are matching production more closely to need, and partly because your kidneys are getting better at retaining it instead of spilling it.

(Jordan Sprott) #4

Thank you, I hope that’s the issue. I’ve never been diagnosed diabetic and had no health issues previous, so would hope I’m not! I will keep monitoring and see how it goes

(You've tried everything else; why not try bacon?) #5

There’s a video of a workshop Dr. Phinney did last year at one of the Low Carb Down Under events, in which he askes the audience what the highest ketone level was that anyone had seen. One guy said something like 12.4, and Dr. Phinney didn’t seem particularly fazed.

A little reading reveals that diabetic ketoacidosis usually involves a high serum glucose level as well as out-of-control ketones. @richard could probably tell us whether the high serum glucose is essential for ketoacidosis to happen, or whether it’s just seen because people are eating the standard American diet.

When we eat a ketogenic diet, serum glucose is not likely to be a problem, since the only source of glucose would be gluconeogenesis in the liver. Gluconeogenesis and ketogenesis are both stimulated by glucagon and regulated by insulin, so as long as your pancreas is producing insulin, theose processes are unlikely to get out of control. When produced, the insulin gets shunted directly to the liver first, before it gets released to the general bloodstream—so even if your pancreatic islet cells are failing, if they are producing any insulin at all, it will have the maximum effect possible on the liver, even if it isn’t enough to act effectively in the rest of the body.