Blood Glucose level dipping too low on keto but very low ketone blood concentration. What should I do?


(Annie ) #1

I have been on a keto diet for exactly one month. I don’t have diabetes or anything. I just need to lose about 100 pounds. I am 30 years old and female. Before I started keto, I had a complete blood test at my donctor’s office and my fasting glucose level on a high carb diet was 81 mgr/dL.

I started with ketostix in the beginning and they would sometimes turn medium purple and sometimes show me out of ketosis. So I got myself a blood ketone meter and have been testing for 3 days now. My blood ketone levels were 0.0, 3 days ago, despite consuming less than 50 gr of carbs. My blood glucose levels after lunch on the first days were 81-83 mgr/dL.
I reduced my carbs to less than 20 gr for two days and today, the highest reading I got was 0.4 mmol/L I later started feeling very jittery, cold and without energy so I measured my BG and it is hovering around 62-65 mgr/dL apparently and my ketone levels have again dropped to 0.2 mmol/L (several measurements show the same).
What is happening? I am not losing weight either if that is of any interest. I am not hungry at all and I am down a whole dress size since I started.
Additional information: I have been on a keto diet twice before. Once in 2016 and once in 2018. Of course I had only ketostix back then and despite eating more than 50 gr of carbs, I lost about 20 lbs each time within 2-3 months.
I weigh everything I eat and log it into MFP app, about 1500 kcal. I don’t now what’s happening. I feel so faint and miserable right now that I am considering eating some carbs. I once fainted in the shower on a 24 hour fast despite drinking enough, so I am a bit scared that might happen again.
Any suggestions and advice would be much welcomed.

(Bacon is a many-splendoured thing) #2

If your scale number is not changing but you are down a dress size, then you are losing fat and gaining an equivalent amount of lean mass. Congratulations! The way of eating is working as advertised.

If you are feeling cold, you are probably not getting enough protein. Try eating a bit more, and see if that helps. Also, be sure to eat to satiety, and not to a specific number of calories, as the latter can signal to the body that there is a famine going on. We want the body to feel safe parting with its excess reserves of fat.

(Bob M) #3

Being cold might mean you’re not eating enough, particularly if you’re fasting (which, by the way, I did not do for 1.5 years after starting). You say you’re not hungry? Even though you’re cold?

Personally, I’d give up fasting for at least a month or more. You should never faint while fasting.

I think you need a longer transition time. One month is not long. Those are low blood glucose numbers. I have to fast 4-5 days before I get those (but I don’t feel bad at all at those levels).

Now, being cold can also be associated with other things, like thyroid. Have you had a complete thyroid test lately?

My advice? Take a step back, relax. Be calm. If you want to fast, eat fewer (but bigger) meals. If you can, attempt to eat away from bedtime, but I for one can’t do that. If you’re cold, try eating more or more fat or more protein, it’s up to you. If that doesn’t work, try getting a thyroid test done, or taking smaller amounts of iodine might be useful. (Iodine can be overdone, so start with smaller amounts.)

At some point, when you feel as if your more stable and warmer, then start fasting if you want. And fasting is not a requirement, though I have perceived benefits from it.

As always, adding salt and/or magnesium and/or potassium is a good thing. Salt first, then Mg, then K probably.

(Michael - When reality fails to meet expectations, the problem is not reality.) #4

See this:

Stop with the fasting already! Eat more fat and protein. Eating carbs will only delay resolution. Don’t.

A lot of stuff happens when you begin keto. You have to give yourself time and sufficient energy for it to do so. Otherwise, you get what you describe.

Best wishes.


Your ketone levels don’t matter and don’t correlate to fat loss. You’re clearly doing everything right, continue on. On the blood sugar, 62-65, that’s not too low, are you feeling hypoglycemic when you’re down there? If not don’t worry about it, or raise your carbs up a little if it makes you feel better.

On the fat loss stall (really to early to call it that) Are you tracking macros other than carbs?

(Butter Withaspoon) #6

It’s probably too late to respond now, but I would try some salt dissolved in water , maybe Half a tspn in one glass to see if that helps you feel better. If it doesn’t I’d eat something, not necessarily carb heavy just something. If you feel unwell while fasting the usual advice is to end that fast.

How are you feeling now?

(Annie ) #7

Thank you for your answers.
So on friday I was feeling really miserable and I ate some carbs, however things didn’t improve that much. I don’t know why but later that night I took my body temperature and I had a fever. It went downhill from there and I came down with some type of stomach virus. I had fever, headache and other unpleasant stomach issues that are slowly getting better. I did a covid test which came out negative.
My doctor told me to give my GI some rest so right now I am avoiding fat and only eating small amounts of plain rice, grilled chicken and plain yogurt. It’s not keto but I can keep it down.
I guess it wasn’t really a keto diet issue. I will continue with keto next week when I have fully recovered from this nasty stomach flu and incorporate your tips!

(Annie ) #8

Actually I did eat some salt and then drank water before I got sick and that really helped me since my blood pressure was already quite low. Thanks for your suggestion.

(Jane) #9

Sorry you got the crud and hope you are feeling better soon!

When my dog was having digestive issues we fed her white ricet, chicken and yogurt and it really helped.