Hi. I’m a keto newbie. Been at it for a month. My blood keto reading is all over the place.
Tues morning is was 2.8 (great fatty dinner mon night)
Wed morning was .8 (unintended 24 hr fast Tues)
Thurs morning .8 again. (High fat low protein dinner)
Carbs always 20-30 per day.
All US measurements. Goal is weight loss and lowering blood glucose.
Am I doing it wrong???
You are in ketosis, so you are not “doing it wrong.” Just as levels of other things in your blood constantly change, so too do your ketone levels. The level of β-hydroxybutyrate in your blood is determined both by how much is being produced in your liver, and how much is being taken up by your cells as fuel. As you can imagine, production and consumption rarely match precisely enough to keep the serum level constant. Variation is to be expected.
You may or may not be aware that the liver produces three ketone bodies: β-hydroxybutyrate, acetoacetate, and acetone (this last is usually not produced directly, but as a breakdown product of acetoacetate). Strictly speaking, β-hydroxybutyrate is not actually a ketone by the chemical definition, which is why we often use the term “ketone bodies” to describe the three chemicals, since they are related and are produced by the same processes in the liver. All three ketone bodies can be used as fuel by many of the cells in the body, although the muscles prefer to metabolise fatty acids (ketone bodies are intermediate metabolites of fatty acids, much as charcoal is an intermediate combustion product of wood). Β-hydroxybutyrate is the principal ketone body and has hormonal effects as well as being used as a fuel (this is true, as well, of acetoacetate, but to a lesser extent).
The definition of “nutritional ketosis” as a level of serum β-hydroxybutyrate of 0.5 mmol/dL or above is actually rather arbitrary. The term was coined by Stephen Phinney, M.D., Ph.D., and Jeff Volek, R.D., Ph.D., to distinguish it from diabetic ketoacidosis, which is a dangerous, life-threatening condition that can afflict Type I diabetics who are not careful with their insulin intake. Dr. Phinney has stated that they picked 0.5 as the level at which they generally see the benefits of ketosis begin, but many people do just fine at a lower level than that. A level of 10.0 or above starts to be concerning, because of the risk of ketoacidosis, but ketoacidosis is highly unlikely in anyone whose pancreas is producing insulin.
I hope these somewhat random thoughts will illuminate your thinking and put your mind at ease.
Huge thanks!
Great info. It’s hard to find good info on fluctuations but this makes perfect sense.
Your levels are good. You don’t want super high numbers, you want to have your body burn the ketones, so don’t chase higher numbers.
Since testing blood is painful, messy and expensive (depending on the meter and cost of it’s proprietary test strips), most folks don’t measure their ketones frequently enough to discover just how variable they are. If folks measure once per day or even less and happen to get the same or similar results, they mistakenly think that’s what it must always be more or less. But it’s not. If you bite the bullet and test your ketones hourly for a day or two, you will see just how much they vary.
Unless you have a medical condition whose treatment requires a specific concentration of ketones (β-hydroxybutyrate) don’t obsess over numbers. If you have measurable ketones you’re in ketosis. If you stay sub-20 grams of carbs per day and remain conscious you’re in ketosis. That’s all that matters. Good things happen in ketosis that otherwise don’t.