Dejected as I have stagnant A1c after 2 months on keto


( #1

Hi Guys,
I’ve been on keto for about 2 months now, have been measuring ketones daily and most days I am in ketosis (0.5-0.7) and my CGM shows an average glucose of 5.1 , yet my a1c that I recently measured showed no change - stayed at 6.2 percent . LDL increased by 60 points, triglycerides didn’t change and HDL dropped 7 points, am I doing something wrong, I am dejected

(Edith) #2

You are too soon in your keto journey. At two months you are barely even fat adapted. We usually suggest you give yourself at least six months before having your triglycerides and cholesterol levels checked. I think the same pretty much goes for your A1C. Blood cells live approximately 90-120 days, so two months in is not enough time to really see a change in that either.

I suggest before getting downhearted, give yourself another four months and then get yourself tested again. You will mostly likely see your numbers start to shift by then.

(Bob M) #3

I’d trust the CGM more than the HbA1c. As Edith said, HbA1c is based on an average red blood cell life, so if yours live longer, you’ll get a higher HbA1c.

Did you lose weight? If so, that is one reason LDL increases. LDL can increase also because you’re shuttling around energy via VLDL, which turns into LDL.

My HDL took a while to rise. It was below 40 (US units) 6 months after keto. Went from there to the mid 50s or so.

Hang tight for a while longer.

( #5

Thanks so much Edith and Bob! I did lose about 5 kilos - I suppose that explains the increase in LDL. I will be patient and wait for another few months to repeat the tests. appreciate the support :kissing_heart:


You’re in Ketosis if you have Ketones in your blood, period. Don’t worry about the numbers.

As @ctviggen, your CGM is taking constant measurements and averaging them, that’s the REAL number. The A1C is a proxy marker, and it’s not perfect. It’ll come down, but the life of RBC’s isn’t a perfect 90 days, and using them that way is still a proxy measurement either way.

On the cholesterol, 2mo in is too early, don’t waste your time testing it, and when you do, do an NMR, standard lipid panels are useless and tell you nothing. Aside from not getting the numbers that matter, the ones you do get are “calculated”, and low carb eating short circuits that equation.


Welcome to the forums. You are doing very well and it is early days yet. Great weight loss. LDL will rise but that is nothing to be concerned about. The ratio of trig/HDL is much more important.

Wishing you all the best as you continue on your journey.

(Robin) #8

Welcome to the forum. So glad you found us this early in your keto journey. It’s a process that may require patience, but think how long it takes us to get to the point that we NEED to fix our health.

I would encourage you to stop measuring at this point. It can mess with your head (ie: dejected) and sabotage your efforts.
You’ll get there. And it will pay off.
You got this!

( #9

Thanks for all the encouragement and guidance. I am so glad I found this forum - is there any weekly zoom type meetups / support meetings I could get myself into? That would be such help. I need to recognize that it took me years to get to this point so undoing won’t be a matter of months - will be patient and stick to it. On the positive side, I’ve started stabilizing with the keto routine and even enjoy it.

(Robin) #10

No zoom sessions here. It’s possible some members might decide to do that amongst themselves.
I believe someone recently proposed that we start one and there were no takers that I could see.

Be aware that you’ll see a lot of contradictions here. What works for me, doesn’t mean it suits you. others do it differently and it works for them, but not me.

Some measure and weigh every day, some don’t. Some fast, some don’t. Etc etc etc…
Some lucky folks lose a lot of weight quickly, others have a slow but steady loss. I kinda like slow and steady, cuz I know I can maintain.

It sounds like YOU are on the right track! Looking forward to your updates (and questions) along the way. Glad you’re here.

(Bacon is a many-splendoured thing) #11

Two months into a keto diet is far, far, far too soon to get meaningful test results. Wait at least until the six-month mark to even begin to think about testing. Fasting lipids are all over the place till then, and HbA1CM is at best a three-month average of your daily glucose levels, and it is subject to a number of factors, such as how long your red blood corpuscles are living, how well- or poorly-hydrated you are, and so forth.

(Chris) #12

As all these wonderful ketoers have said, you’re early into keto, and you’re still adjusting and changing. For me, I ‘allowed’ myself to take my weight and ketone/blood glucose measurements only once a week, or I’d make myself crazy!! It takes at least 3 months of what I call “hard keto” (net carbs <25) to get into ketosis. And make sure you are getting electrolytes every day - I drink 1 liter of Body Armor water daily, and have never had the “keto flu”. The metabolic process of ketosis uses these electrolytes in a different way than metabolizing glucose. BTW, I’ve been doing keto for almost 7 years now :partying_face: This past Thanksgiving, I went off keto, and am just now getting back on “hard keto” - my body HATED all the carbs, my sugar cravings came back big time, and I gained 10 pounds!!! :stuck_out_tongue_closed_eyes:
I did however monitor my BS, since diabetes runs strongly in our family (that was a big reason for me starting keto, losing weight was too), and it was always under 100 (fasting).
You’re concerned about your cholesterol levels - in my experience, my cholesterol varied - it went up, and the LDL went up. I hung in there though, and didn’t panic. Sure enough, they leveled out at around 195, with my LDL at 108 and HDL at 69 (HDL has been as high as 89), so my Total Chol / HDL ratio is 2.9 — off the charts!! (in a good way!) (I’ll attach a screenshot of the reference ranges).
Eating keto and having your body in ketosis is a scientific process, and this site has a ton of the science behind it. There is also a ton of information on different ways to approach keto - take what you like from it.
Good luck!! You’re doing great!! :+1:


What are your goals? I assume that you are T2D? Every person’s metabolism is different. Some people will lose tremendous amounts of weight and improve their metobolic markers on keto, while others will actually gain weight and see their lipid markers go haywire on the exact same diet. I have seen this play out. It really depends on the individual. What is sustainable?