Blood ketone level clarification


I realize this post is 14 months old, but I’ve been eating ketogenically and running and biking for 6 weeks straight. I rarely measure any ketones with my blood meter. I don’t measure daily, but do measure at least 4x/week. Usually first thing in the morning I don’t register any. Before bed, I’d say the highest I am will be 0.4. I once measured 1.1 during my first week on the diet. ONCE. I’ve been an endurance athlete for 12 years and perhaps I was able to adapt quickly and my body just doesn’t produce much in excess? At least two of my female endurance friends have this same issue.

My blood glucose levels are pretty consistently at upper 70’s to low 80’s.

(Bella Tricks) #63

I was keto 9 months before I started to shed weight - the key for me was adding Intermittent Fasting. Good luck ! :slight_smile:

(Vijay Bhakta) #64

Hi All

Just after a quick validation of my theory following reading up on Keytone levels.

I started lowering my carbs, without counting them about 3 weeks ago, then went full Keto from the 23rd Feb, so I am 12 days in.

I took my glucose and keytone measurements (blood sticks) last Tuesday, after a long walk, and they read 3.8 mmol for Glucose and 3.4 for Keytones. This morning I tool the blood tests first thing in the morning and they read 3.4 mmol for Glucose and 3.2 for Keytones.

What initially alarmed me is that the chart Richard posted earlier in this thread shows the keytone levels to be in starvation mode, but then I read that the levels are a good sign indicating that my body is producing a lot, but still figuring out a way to use them - is that right ?




Sounds right to me.

(Mark Rhodes) #66


(Scott) #67


I’m new to the Keto diet about 2 weeks in. I checked this morning and I’m at 3.5 mmol and glucose at 57. Is that normal? I do incremental fasting from 10am to 6pm.

Thank you


(Jason) #68

Started in June back to tracking again and really trying to hit macros. I’m usually hitting 20-30 total (not net) carbs a day. Still going over on calories, fat and protein a little. Can’t seems to get a decent ketone reading. I’ve been keto for over a year but was stalled doing dirty keto till June 1 when I started tracking again. Is my body just not spilling ketones into my blood or am I foooling myself that I’m in ketosis. I’m very sedentary so I’m not one of noakes elite athletes.

Edit: also noted all my high readings are PM

(May the blessing of bacon be always with you) #69

With your carbs that low, I’d say you are probably ketotic, just using most of what you produce. Unfortunately, there is no way to measure fat adaptation, and ketone levels are the only marker we have.

But how are you feeling? Can you go hours between meals? What is your weight doing? Do you have energy? Have you been feeling warmer than the people around you? Do sweet things now taste excessively sweet? How are your alllergies? What is happening with your blood work? Were you able to cut down on/get off of your diabetes meds/the statin/the blood pressure med/etc.? These are all indicators of progress.

(Empress of the Unexpected) #70

Sorry, quick explanation of the feeling warmer than everybody part?

(May the blessing of bacon be always with you) #71

When fed an abundance of calories, the body ramps up its basal metabolic rate and even starts wasting calories. I don’t know if this actually raises the body temperature, but it does make people feel warmer than usual until they get used to it.

For example, even in the winter time, I am comfortable around the house wearing nothing more than a T-shirt and a pair of gym shorts. In summer, with the house much warmer, keeping cool is a challenge. At age 62, my metabolism seems comparable to that of my teenaged niece and nephew.

(Du Moreira) #72

I’ve been also wondering what’s going on with my low blood ketones readings for the past month. When I started the keto diet 3 years ago, I would almost always get readings above 1.0 BUT (and that’s a huge but…) at that time I almost didn’t lose any weight. I kept going despite not losing weight because my blood pressure and overall energy levels, mental clarity and etc. all improved. The years passed and all of a sudden I started losing weight. I then added IF to the equation and now I’m pretty close to my ideal weight. The interesting caveat, though, is that my readings now are always bellow 1.0, averaging probably around 0.5. I didn’t understand it at first, but now I’m pretty convinced of the ketone usage hypothesis. Losing weight means burning fat stores. When my ketone readings were higher, for some reason I wasn’t burning my own fat. Now I am and all the other signs (lack of hunger, mental clarity, easy fasting, etc.) are also here. The bottom line is: high blood ketone readings are important at the begining, but (probably) not in the long run.

(Bill C) #73

Ketones have never been a problem. Started back into keto 11 days ago. Didn’t check ketone levels until 3 days into it and the first reading was 1.1. It has steadily moved up. Today it was 1.8. But here is the kicker. I eat a lot of carbs. They have ranged from a low of 136g to a high of 238g. I do workout a lot, though, so that must be the only reason I stay in ketosis. I suspect that as I get closer to my goal and my body fat % is reduced the ketone levels will drop.

(May the blessing of bacon be always with you) #74

I’m envious. Eating that much carbohydrate would raise my insulin level too high for me to avoid gaining weight. You must be very insulin-sensitive, for that much carbohydrate to work for you. Have a Krispy Kreme on me! :doughnut:

(Bill C) #75

The only reason I can think of is that I work out twice a day, one hour of swimming, then later one hour of running. I have been told that by being very active you can burn through the carbs. Now, interestingly, I took a blood test yesterday and was only .3. But the day before I had consumed 310g of carbs. Maybe there is a limit my body can take before it falls out of ketosis.

(Bill C) #76

Having been doing this for a while now, I am going to have to question the carb paradigm. I have significantly exceeded 50g of carbs each day but have remained in ketosis. In fact I have been consuming roughly 300 grams of carbs each day and have remained in ketosis. Some may question this but I assure you I have kept detailed records on everything. However what I have been doing in addition to eating the 300 grams of carbs per day is to exercise vigorously for approximately 2 hours each day both swimming and running. So what this seems to be telling me is that if you are very active then you can increase carbs significantly and remain in ketosis. Also my fiber intake has been significant all along so my net carbs are closer to 200 excess carbs per day. Nonetheless they are consistently well above 50 grams of carbs per day.


I just said that staying in ketosis with more than 50 carbs was unlikely, not impossible; activity and metabolic health are highly individual.

I’ve experimented on myself in recent months and I can eat an entire baked potato and still be in nutritional ketosis 2 to 4 hours after as well as the next morning, but I’m still not adding that as a regular part of my diet based on my deranged metabolism as a recovering Type 2 Diabetic.

(Bill C) #78

I think it comes down to two things, amount of carbs being eaten AND level of exercise one is getting. If you are putting in a lot of exercise you can consistently eat well above 100 net carbs per day because your body is disposing of the carbs as soon as they are eaten and you are immediately in the mode of your body back to burning fat. I tend to believe the quality of the macros you are putting into your system is also important. For example, the carbs I am eating are things like fresh blueberries and raspberries, homemade split pea soup, shredded wheat with no sugar. When I hear people saying things like they put large amounts of butter in their coffee or various other fat bombs, I think it is counterproductive even though they may believe they are hitting their macro targets.

(Bob M) #79

I’ve gotten >0.5 or so before a workout and 0.0 to 0.2 afterwards, if I fast 36 hours before the workout and even sometimes if I eat the day before. For instance, last week I was about 12 hours fasted for my workout and was 0.8 before and 0.2 after the workout. Blood sugar went from 103 before to 110 after (divide by 18 to get European units).

After being low carb for almost 5 years, I’m rarely above 1.0 unless I fast a ton (3+ days), but I get into ketosis much faster. For instance, I had potatoes for dinner one day and got 0.0 at 6:19 am the next morning but was at 1.0 at 1:01 pm.

Note that the strips have a lot of error in them. I got 0.6 and 1.0 from two different strips, taken a minute or so apart. (Different blood, different fingers). I’ve also seen 0.0 and 0.7 from two different monitors using two different strips (I have a monitor for work and one for home, same manufacturer).

(Bill C) #80

Yeah, I find it interesting that ketone levels will actually drop after a workout. I only measure after workouts, so maybe I will have to try it a couple hours after the workout to get a more accurate reading.

That is concerning, the variation in ketone levels. You wonder about the accuracy altogether if there is that much variation in a matter of minutes. That would seem to indicate they are not that accurate and it is said regularly that blood testing is the most accurate. Hmm…

(Bob M) #81

Here’s a test I did.

I think I made only one poker per finger and dipped both strips into that one blood bubble for the 12:14, then used a different finger (but only one poke again) for the 12:16 test.