Concerned with high ketones

#1

Should I be concerned that my ketones were registering at 7.0 this morning and glucose was 73? I have been checking my ketones more frequently this week since the new meter arrived. The first day checking was getting ketones of 5.0 and glucose 97. Second morning ketones was 2.4 and glucose 95. Now today ketones 7.0 and glucose 73. These readings are all in the fasting mornings. I’m worried if this keep trending up that it’ll dangerous. Backstory. Keto turned zero carbs high fat for over a year now.

(You've tried everything else; why not try bacon?) #2

Welcome to the forums!

I’m not sure what your concern is, but I’m guessing you think your blood sugar is too low and that you are in danger of diabetes ketoacidosis. Let me assure you that you are fine.

When we fast, or when we eat a low-carb/ketogenic diet, the body normally has a much lower serum glucose level. There are very few cells that actually require glucose to live, and the principal ones are our red blood corpuscles (erythrocytes), which lack the mitochondria to metabolise fatty acids (presumably this is because they need to be small enough to fit through capillaries). The result is that the body actually needs no more than 5-6 mg of glucose in the blood stream, under normal conditions.

The brain needs energy, of course, but that energy can come from either glucose or ketone bodies. There are signs that the brain actually prefers ketones, when it can get them. While it is an open question, apparently, whether the brain actually needs any glucose at all, there is no question that it needs a lot less than is usually believed. It probably needs some glucose, but not very much when ketones are abundant.

Diabetic ketoacidosis is not a concern in anyone whose pancreas is producing insulin. And the diagnostic criterion is a serum β-hydroxybutyrate level of 10.0 or above (and symptoms don’t appear until β-hydroxybutyrate reaches 20.0) combined with hyperglycaemia. So if that’s where your body were headed, you’d see elevated numbers for both glucose and ketones. So you’re fine.

It has to be said that there is a condition known as “euglycaemic” ketoacidosis, but that occurs only in patients taking a certain class of drugs (SGLT-2) inhibitors and sometimes in women on a ketogenic diet who attempt to fast during pregnancy or lactation (it is fine for ketogenic women to fast at other times).

(Robin) #3

Welcome to the forum. Love it when a “newbie” to us is not a newbie at all. Looking forward to your participation!

#4

That’s not high, especially first thing AM. Best way is to ignore your ketones completely, as the number makes no difference as long as you’re eating correctly. Same goes for blood glucose assuming you don’t have a A1C in the diabetic range.

(KCKO, KCFO 🥥) #5

Those are both good numbers.

Welcome to the forums.

(Michael) #6

How much protein are you eating in a day? While a high ketone is safe, it also means you are not using energy in the blood (like high blood sugars but in this case with ketones and without the damage caused by sugar). You need enough protein to make ketones and then use them as well, which is why I ask.

(You've tried everything else; why not try bacon?) #7

From the sound of things, this person is probably fairly new to a ketogenic diet, and the ketone level will likely drop over time, as the muscles readapt to metabolising fatty acids and the liver gets more parsimonious with ketogenesis.

(Michael) #8

Except they state they have been keto for over a year, so no such luck.

#9

I stopped taking my ketone readings for that it will only worry me. I’m going with how much body feels. my A1C was 5.9 not great but not bad I think. For the past few days with the registering high ketones and lower glucose, I’ve noticed a lot of changes in my appetite. I haven’t been hungry at all. I will try to listen to my body and eat when hungry and not if not hungry. I don’t know if having the higher ketones reading and low glucose have anything with it.

(Bob M) #10

7.0 is fairly high, but not critically so. Some people seem to have less hunger (and/or better mental acuity) with higher ketones. (This could be an insulin effect, too, as typically lower insulin allows higher ketones; but we can’t measure insulin.)

But with time, your ketones should come down, as your body gets better at using/producing them.

(You've tried everything else; why not try bacon?) #11

Ah. Given that many of our members who have been keto for a year would love to have “ketones of 7.0 and glucose of 73,” that’s actually a pretty good problem to have.