Blood ketone level clarification

(Ethan) #22

This is somewhat normal. How long have you been on a ketogenic diet? Are you diabetic? Ketone numbers tend to be lowest in the morning for those of us on a ketogenic diet–and diabetics tend to have an even more pronounced variance between morning and evening levels.


I have been on a ketogenic diet for three months and am not diabetic.

(mike) #24

Pretty much looks just like mine.
Here’s one day from mine this week
Morning .4
midday 1.2
evening .9

I do find it depends on what I ate the night before. If I am very strict on carbs, almost none, then it can go higher. But As long as I’m below 30ish carbs I’m good.


Do you ever have a dry martini? I have for several nights and am wondering if vodka is affecting these numbers.

(Brian Nace) #26

So Dr Phinney
and Volek finished their company’s clinical trial and they closely managed 235 participant for intake etc. for Ketogenisis. And here is their Ketone level:
"Program Adherence
Daily BOHB level averaged over 10 weeks of the program was
0.6 (SD 0.6) mmol·L−1 (see Figure 1). This range is indicative
of a modest state of nutritional ketosis in most of the subjects,
with highest value similar to levels observed during fasting.
There were no cases of diabetic ketoacidosis (ie, hyperglycemia
concurrent with serum BOHB level >6 mmol·L−1)"

(Stephanie K LENNON) #27

I am new on this forum. I’ve been doing the low carb thing off and on for years. I just bought a blood glucose monitoring system. I’m trying to keep my carbs under 20 net carbs . The strips are reading .5. I am confused what is the optimal level for me. I am a woman 54 light activity. I drink a lot of coffee and artificial sweetened beverages. Could someone please give me some advice.

(May the blessing of bacon be always with you) #28

How long have you been on a well-formulated ketogenic diet? I don’t test, myself, but from what I’ve picked up, ketone levels are highest when one first enters nutritional ketosis, because the body is not yet fully adapted to using them. Later on, levels tend to drop as the body becomes more efficient at burning fat.

Remember that ketones are the result of the incomplete oxidation of fatty acids, so as your metabolism of fat improves you are likely to see fewer ketones circulating in the blood or being exhaled or excreted. The important thing is to be in nutritional ketosis, the actual level of detectable ketones is really not an issue. Dr. Phinney says that the employees at Virta Health sometimes get carried away by trying to achieve the highest possible ketone level, and he then has to remind them that (a) they had better not be giving any indication of this competition when they talk to patients, because (b) all that matters is whether people are in ketosis or not.

If you are in ketosis at all, it means that your insulin level is low enough for your body to mobilize and metabolize its stores of fat. If you are seeing weight loss or signs that your body composition is changing (loss of inches in strategic places, etc.), then you are in good shape and have nothing to worry about. So it’s not about the level shown on your ketone meter, or even really about ketosis, either—it’s about whether you are seeing physical and medical improvements.

(Stephanie K LENNON) #29

Thanks, that was very helpful. I have been at 20 grams for about 3 months, and have lost about 15 lbs… It’s just coming off slower. I am about 13 pounds from goal weight, so I guess the loss is slowing down.

(Stephanie K LENNON) #30

So, at-.5 blood glucose still in ketosis?

(Adam Kirby) #31

Since you’re not doing a ketogenic diets for neurological benefits, your level of ketosis literally doesn’t matter. What you are looking for is to be in a state of lipolysis, which doesn’t always correlate with high measurable ketones. This article explains who should worry about ketone measurements and who should not.


What are your blood glucose readings? That provides the context for determining the degree your body is fueled by fat vs glucose. The GKI index is calculated by dividing BG (in mmol) by ketones. There’s a useful chart here:

Also, the effect that artificial sweeteners have varies by individual. Some have no impact on some folks, some inhibit weight loss in others. Test it for yourself by seeing if the ones you’re using illicit a change in your BG.

(bulkbiker) #33

If your blood glucose was 0.5 you’d be dead… I think… It sounds like you are measuring ketones not blood glucose.
What is your meter and what does it say on the packaging on the test strips you are using?

(Stephanie K LENNON) #34

Sorry. 5 keytone monitor… This morning the blood keytone monitor read “low”.I bought a glucose meter and it wont even come on. I’m going to take it back today and get another and test the glucose levels now. I’m reading that a lot of protein could also affect the keystone levels, Which I’m probably eating more of and not enough fat for sure. At least that’s what I’m reading on the internet.

(Julie Anne Porta Pt) #35

I have been on it for 9 months but to be honest im not strict with it as i do carb cycle and what i mean by that is i will eat keto for 2 weeks and then maybe have a weekend off (socially is usually the reason so its not the cleanest cycle either).

I have noticed that i have actually gained weight and not my usual set point weight which is what made me question my high levels of ketones. I am testing out now not having any mct oil as u mentioned.

How i feel? I am finally able to sleep in the 45 years of my life. I do notice when im in heavy ketosis i dont sleep…chatter brain and not tired. So i am loving the sleep factor as i did learn tryptophan needs some insulin to break the brain barrier and provide serototnin.

I do appreciate all of your replies. Thank u so much.


I don’t at all “ get” why to take exogenous ketones, if not needing the ketones themselves for something neurological ( or other ) or to get past “keto flu”. Then it’s a medicine, I’d say.

Seems if we’re testing our ketones to see if we have put ourselves in ketosis by altering our intake so to start burning fat instead of carbs, then eating ketones will just confuse this measure (!)

Just bought a Precision Plus ketone meter and my blood had 0.6 mmol ketones. Yay ! I’m losing pounds and feeling great so this must be real.

Now to work out :weight_lifting_man: ha ha work out how to up my carbs enough to add back my organic vegies without losing this ketotic state. I might actually wait until I hit my goal and stay there a few days to a week - 8 pounds to go !

Thanks for being there everybody - love to read what people are thinking and writing !


(Kate M James) #37

Hello people - I’m another newbie and only began a low carb diet (mainly for weightloss purposes) earlier in the summer. It was an erratic start as giving up croissants was tough!! In August I measured my blood glucose & ketone levels and then again today as I don’t want to use up too many sticks as they can be expensive.
So in August,
blood glucose: 6.2, ketones: 0.2
today (3 Nov 17)
blood glucose: 4.8, ketones 0.7

Can someone educate me on the situation - am I in ketosis, going into ketosis or not?

I eat very few carbs - although do rather like smoothies that contain:
avocado, double cream, almond milk, and a small handful of strawberries, raspberries and blueberries which may well up the carbs. I also add in a cupful of water and a spoonful of flaxseed powder.

Lunch and Dinner often comprises meat with veggies. Breakfast may be a smoothie or scrambled eggs with some salmon added.

Grateful for some assistance on this new journey!

Thanks to all who reply :slight_smile:


Ketones give us info about our state of lipolysis, but blood glucose is a proxy for insulin, the hormone largely responsible for weight (fat) gain. Sure it’s nice to have both sides of the equation, but measuring ketones is expensive. Fortunately, measuring blood glucose is cheap, and can provide a lot of information.

If you have metabolic syndrome or you’re insulin resistant (most significantly overweight people are) your basal insulin is to high. Eating a LC diet, intermittent fasting and extended fasting is effective treatment.

How do you know if what you’re doing is working? Measure your fasting glucose every morning. Over time you want it to go down. How do you know how your body is responding to what you’re eating? Measure your glucose after you eat. For example, if I eat a high carb meal, my glucose will shoot up to 144, whereas if I eat a HFLC meal it will stay under 100. Here’s another example. Our physiological responses to artifical sweeteners vary tremendously. Some sweeteners elicit a insulin response in some folks and others are effected by different ones or not at all. How do you know which ones effect you? Measure your glucose.

Sure, its nice to track ketones, but if I could only do one, I’d pick glucose.


Most plain alcohols 80 proof and abound have no carbs. Just alcohol calories which stop ketone production cause the liver prioritizes alcohol burning.
As for your numbers looks good and follows what I’ve tested. Lower in the morning and higher in the day/evening. I’ve been keto for 3-4 months now and didn’t start blood testing till after the first month. Was well adapted by then, used IF to speed things up plus a fast metabolism
(10-15% bf) Lost 15lbs in 2-3 weeks and wasn’t even trying, dam fat phobia when I started. I’ve never measured over 0.6 usually always in he morning after at least 12 hour fast. The few times I’ve test in the evening I’m ~1.0 always under 30 net carbs. Why everyone thinks higher is better is beyond me. Unless you have a medical reason for higher ketone levels. All it means is your producing more than you use. (Now if we could correlate the blood to the breath since thats used ketones that would be useful. Just a theoretical example if one made .5 ketones and used .4 equals a net of .1. But if one made 4.0 and used .2 equals net of 3.8 we would all assume the one that using more would be more fat adapted while with just the ketones one would assume the 4.0 is better.) Long time keto follower report that ketones drop when you become fat adapted. Your better at producing just what you need and and use also your muscles start using free fatty acids for fuel instead of ketones. Some of Phinneys althele subjects ketones level we’re .2-.3 and they were burning the most fat! It’s all about results, stop chasing ketones.

(Kate M James) #40

Not too sure as to what people mean with the above - are my levels showing a move towards ketosis or not?

I’m about 69 kg in weight and want to lose more - my stomach has “stubborn” fat, I’m aged 57 and was always stick thin growing up (until my divorce some 12 years ago!). I like a glass of red wine every so often which is prob my weakness at the weekends…

Thanks :slight_smile:

(May the blessing of bacon be always with you) #41

According to Dr. Stephen Phinney, who invented the concept of nutritional ketosis, a beta-hydroxybutyrate level of 0.5 or greater means you’re in ketosis. He cautions, however, that people who are extremely well fat-adapted, such as endurance athletes, can still be in ketosis with much lower rates. He also cautions not to take a higher level as being necessarily better, since the level of ketones in your blood doesn’t necessarily indicate how well you are metabolizing fat.