Hi! I’ve been eating Carnivore strictly for 7 days (loosely, more Keto, for about 3 months prior). My Blood Glucose Level usually stays in the low 80s high 70s range. However, this morning it dropped to 67! Yikes! I don’t want to eat sugar to get it back up in the normal range. Any advice would be so appreciated! I’m not sure why it fell so low🤔. Thanks!!!
How do you feel? Mine drops to the 50s when I’m fasting and personally I’d be delighted to see it at 67 in the morning if not fasting.
Low blood sugar levels can be dangerous if chemically induced (from insulin, for instance) but if it’s just because your body is running mostly on ketones and you’re feeling fine, then there’s probably no problem (quite the contrary - it’s great for your overall healthy, your organs, your longevity…).
(Also - welcome!! this is a great community)
Are you taking any blood glucose lowering medication?
If not then great…
if you are then maybe think about reducing it (after quick discussion with your doctor of course).
I am assuming that you know your glucose was low only because you were testing for it. If you felt symptoms of hypoglycaemia when at 67, then that is a problem, but if you felt fine, then the 67 is nothing to worry about. People on these forums have reported occasionally dropping into the thirties and forties with no ill effects.
Blood sugar levels are usually related to our carbohydrate intake. The actual amount that the body needs to be circulating in the blood at any one time is around 4 or 5 grams—a U.S. teaspoonful. Very little of the body actually needs glucose in order to live, the main exceptions being our red blood corpuscles and certain brain cells (and whether the brain actually needs any glucose at all is currently in dispute). The vast majority of the cells in our body can easily metabolise fatty acids (the muscles’ preferred fuel) and ketone bodies (which the brain and the heart thrive on).
When we are in a state of ketosis, our need for glucose is therefore quite low. A famous experiment by George Cahill in the 1960’s involved subjecting the research subjects—who were in ketosis because they were being starved as part of the experiment—to an insulin “clamp,” which was used to drive their serum glucose to extremely low levels. The subjects reached levels of serum glucose low enough to cause hypoglycaemic coma (far lower than your 67), but completely without ill effects. As Dr. Stephen Phinney describes the experiment in a fairly recent lecture, “the only people experiencing sweating and palpitations were the ones in the white coats.”
The experiment was highly unethical, and no institutional review board would ever countenance anything similar today, but it was illuminating. The reason the subjects of the experiment were fine was that they had been in ketosis long enough for their brains and muscles to be fine metabolising fatty acids and ketone bodies in place of glucose. In the context of a low-carbohydrate diet, the body has a mechanism in the liver, called “gluconeogenesis,” which uses a small amount of protein to produce what little glucose the body actually needs. Your carbohydrate intake can be at zero grams, and you will still be fine.
ETA—Mark raises an important point, which is that if you are eating a ketogenic diet while taking medicine to control your blood sugar, you must consult with your physician to adjust or stop your dosage(s). Metformin is the safest of such drugs, but even the dose of that will probably need to be adjusted.
Thank you! That is so helpful! I was in a fasted state…actually had my last meal at 4:30 yesterday which isn’t typical for me! It all makes perfect sense now! Truly appreciate your insight!
Wow! Loved this explanation! Makes perfect sense to me now! Thank you so much!!!
And you’re worried because… you feel bad? If that’s not an issue don’t worry. Mine drops to 50s sometimes.
A reference to it I saw claimed some patients were down to single digit blood glucose numbers…
In mmol/l rather than mg/dl though…
That wouldn’t make sense if they were in the 30 to 40 range, on ketosis after an extended fast, before getting the insulin “clamp”?
A single digit mmol/l would be unremarkable, would it not?
Well as 9 in mg/dl would be 0.5 mmol/l then I think single digit would be fairly dangerous… even in ketosis…
Phinney was talking about 2 mmol/l so far as I recall.
That was the point of the [unorthodox] experiment.
There are those that think 60 mg/dl is fairly dangerous … even in ketosis …
In the end, the real test is how someone feels. A “too low” blood sugar has some pretty obvious symptoms that couldn’t be ignored. But the “too low” value does appear to be significantly different dependent on whether someone is using glucose or ketones as the primary fuel.
I would be curious if GNG is spewing out more glucose as the blood sugar gets lower and lower.
Well death being one of them I guess… possibly not the best outcome whether in ketosis or not…
Death can also occur from too many ketones. Such extremes aren’t relevant. They require special circumstances.
The lowest mine has ever been was 52 after 3 days of fasting. My ketones were over 7 so had an excellent ratio! Felt great!
To some extent, this is likely. But it depends on other parameters, as well. There is a lot of redundancy in the system, since our survival depends on it. And the point is that ketone bodies can substitute for glucose in very many organs, to an extent not understood before Cahill’s work.
It was George Cahill who published the estimate, now taken for granted, that the brain needs 130 g (or 150 g? but somewhere around there, anyway) of glucose a day. Nevertheless, Benjamin Bikman, who considers himself something of a disciple of Cahill’s, questions that figure and asserts there is no actual evidence that the brain needs any glucose at all—as long as there are ketones circulating to take up the slack, of course. There seem to be significant differences between the body’s needs on a high-carbohydrate diet and its needs on a proper human diet.