I calculate both ratios so that I don’t have to worry about whoever I am speaking to knowing one and not the other.
Dr Boz Calculates levels of autophagy using blood sugar/blood ketones ratio
daddyoh
(Eric - The patient needs to be patient!)
#27
Herb_Martin
(Herb Martin)
#28
I wrote the following before reading all of the comments – which do seem to confirm most of my suppositions. At the risk of confusing someone, the post is as originally written but I am going to re-read Karim’s info which is very helpful (though I don’t fully understand his graph yet) and additional references to GKI.
About minute 22-26 in Dr. Boz’s linked video Autophagy and Glucose Ketone Ration
Glucose Ketone Ratio needs to have UNITS specified to keep this straight.
Glucose in mg/dL makes 100 a sensible reading
Ketone in mmol(/L) is what makes sense with the numbers you are giving.
Seyfried uses a conversion factor with these units rather than a straight ratio but then doesn’t give a set of clear targets (that I’ve found) but seems to want cancer patients at less than 1.0
So Seyfried’s Glucose Ketone Index (GKI) looks to be a factor 18.016 (Glucose to mol conversion) smaller than Dr. Boz Glucose Keto ratio. (His 1.0 would be her 18 or approximately 20)
Both of these would be different numbers of either of the 2 measurements were using different units.
Seyfried’s paper comes with a spreadsheet link for calculating his GKI, and giving all the conversions.
Being math oriented it is confusing me so my guess is that it will confuse others – or they will get it correct by accident or wrong by reading meters differently.
My current levels from #CarnivoreDiet onto a 70 hour fast were:
Glucose 103 mg/dL
Ketones 0.9 mmol/L
= Seyfried GKI of 6.41
= Dr. Boz ratio of 114
(Which seems quite a bit higher than I expected though I may be well adapted to ketones at this point rather than having trouble making them
Also, even were my Glucose to drop to 80, it would still miss as a longshot autophagy indicator.
On a side note:
At 70+ hours of a water fast, I’m dropping weight by the kilo, about 3 lbs per day, and this is following losing 50+ lbs and being on Carnivore or Keto diet for many months (8+)
My Ketostick is going moderate to large almost immediately even though the (new) meter shows only 0.9 mmol.
(nominal 40 second developing time on the ketostick)
I have been using the sticks for decades to gauge ketosis so having such seemingly poor correlation is confusing.
Herb_Martin
(Herb Martin)
#29
Karim,
Where did the table originate?
It doesn’t look to be a simple conversion from GKI to Dr.Boz and I didn’t find it (yet) in the original reference on GKI from Seyfried.
Going to follow the other references in case it is one of those.
Thank you, and thank you for posting all of the above info and personal logs.
KetoCancerMom
(Cancer Fighting Ketovore :))
#30
Here are what my numbers are looking like:
The BG (glucose) and BK (ketones) numbers are taken before I eat.
So the numbers for March 1 are the macros I ate and the readings from the next night, at supper on the 2nd (so it reflects the meal on the 1st).
The color codes are my own, based on protein targets (based on weight).
For GKI: green (not shown, is 1 or less), light yellow (between 1 and 2) and dark orange (between 2 and 3), and red (above 3).
Karim_Wassef
(Karim Wassef)
#31
Martin,
Which table do you mean? I just use the GKI formula and plot it myself. Here’s the reference posted previously by someone else for ease:
Karim_Wassef
(Karim Wassef)
#32
Here’s my GKI for the week so far:
Check out my fasting thread for more details:
It tooks me 3.5 days of continuous fasting just to break into moderate autophagy (GKI<3) and around 4.5 days to get around or under GKI < 1 consistently.
OldDoug
(Doug)
#33
Question for everybody - if you know, or think you know, or if you’ve read something or if you just want to run outside and shoot guns in the air.
The level of blood ketones during fasting - what all controls this? The liver is making ketones from fat, powering most of the body this way. Yet people vary substantially in their blood level, no? I don’t know if it’s generally true, but have heard stories of the ketone level going down over time, apparently as the body gets used to the process and doesn’t produce as much excess.
Karim_Wassef
(Karim Wassef)
#34
that is true.
the body bets heavy when it doesn’t know what’s coming.
once it figures out what the pattern is likely to be, it pulls back and tries to be as conservative as possible.
KetoCancerMom
(Cancer Fighting Ketovore :))
#35
So, even doing OMAD, if not trying to lose weight, you still need to “mix things up”?
daddyoh
(Eric - The patient needs to be patient!)
#36
Good questions. Don’t know. I’ve only got a few sets of measurements.
Longer fasts tend to produce higher ketones. Ketones however are lower in the morning regardless because I still suffer dawn effect.
My BG is just coming down (reversing insulin resistance?) so I expect that to improve my GKI ration.
I do assume that going into a fast with minimal carbs consumed the day before that would be a positive affect on ketones. But I normally am <20g/day.
I’ll be interested in other people’s answers.
I’m fasting now (24+ hrs) and will measure just before I break the fast. Hope to go to dinner time but only time will tell if I go longer or break sooner.
Karim_Wassef
(Karim Wassef)
#37
If you want you body to use more energy than it wants to (conservatively), then you need to mix it up - if you don’t confuse it, then it will figure out the pattern and optimize.
This effect is very long duration. If I eat during the week and fast on the weekend, it figures that out. If I eat 4 days and fast 3, it figures that too. If I OMAD - yup, it’s got me. If I lift at the same time every other day - yup, got that covered too… Imagine a mini-you sitting on your shoulder literally keeping track of everything you do and trying to figure out what you’ll do next… and then reducing your energy expenditure when you do it…
OldDoug
(Doug)
#38
Eric - yes, it makes total sense that longer fasts would bring higher ketone levels. Not sure exactly how long the body would still be running on glycogen from past eating - a day or two? Obviously, extremely low-carb keto eating should mean not much glycogen stored, beyond what the body really thinks is essential - that it will ‘fund’ via the liver making glucose out of fat. Still, after a while I see the “carb stores” being at minimum and the easiest stuff to recycle via autophagy being consumed (if any of that goes to energy) - and at that point the body has to totally concentrate of fat-burning and ketone-making.
I’ve never tested myself for ketones, and don’t have any scientific surveys at hand, but seems to me that one person’s 5 or 6 or 7 is another’s 2.5 or 3. If we are plugging such variable numbers into an “autophagy index,” then I’m wondering how accurate it will be.
Same for glucose - Karim hit a 39, I was at 90 last time after 5 days fasting, and a buddy of mine (severe blood sugar control issues) was still over 200 after 3 days fasting. I don’t see this as totally confounding - higher blood sugar should mean higher insulin should mean lower autophagy. Yet perhaps one should ‘calibrate’ one’s numbers before assuming the level of autophagy?
Karim_Wassef
(Karim Wassef)
#39
actually I hit 36 
and my ketones were only 3.8 at the time… I think that my body actively took that cue to push ketones up into the high 5s after that.
KetoMojo Anomalies
daddyoh
(Eric - The patient needs to be patient!)
#40
Doug
I think there just is not enough autophagy knowledge available or know yet. I read Megan and Brenda talk about Dr Fung and his fasting patients never needing skin removal. So from this I take that autophagy is real. I’m just assuming that 36 to 54 hrs is enough for now for autophagy.
Already I’m taking away from this discussion the need to mix things up.
Herb_Martin
(Herb Martin)
#42
First, depends on your glucose and glycogen stores when you start deep ketosis diet.
Your liver and muscles store glycogen as well as some other tissues.
Then how must exercise you do – exercise will burn the glycogen in the muscles primarily at first.
Of course it also matters how strict you are, and how efficient your body is at mobilizing fat, so even your fat content, especially in your liver and pancreas.
A big goal for most people will be to clear the fatty liver and fatty pancreas.
Then according to Dr. Boz’s book (and other sources) your tissues will switch over to using fatty acids and burning ketones at different rates. Some will switch early and more completely while others will take months to switch to primarily or even heavily.
As more and more of your tissues switch to burning fat for fuel the excess in the blood, and particularly the spilling into urine (as measured by ketosticks) will likely drop down.
I am fairly new to this part of keto diets (autophagy and measuring blood ketones) so I could be wrong about some of the above.
As of today, end of 5th full fasting day (12 days end of last month):
GKI 1.03 DrBozRatio 19 (BG 78 mg/dL, Ketones 4.2 mmol/L)
This puts me right at the edge of “Deep Autophagy” (and below “Deep Ketos, therapeutic autophagy”) from this table:
0-1 very deep autophagy
1-3 deep ketosis - therapeutic autophagy
3-6 moderate keto - functional weight loss
6-9 low keto - weight maintenance
9-12 (or higher) - no ketosis, highly anabolic (fat or muscle depends on demand)
For others, my main issue on the previous 12-day fast was keeping my electrolytes balanced. Watch out for that.
Thanks to everyone above for your help and comments, especially Karim_Wassef
Don_Q
(Windmill Tilter)
#45
I’m a member at the IDM clinic, and the weight loss course recommends two 42 hour fasts a week for weight loss. That’s it. They also run a monthly Zornfast of up to 7 days each month, which is encouraged but optional. That level of fasting appears to be enough to trigger the autophagy necessary to deal with excess skin.
Herb_Martin
(Herb Martin)
#46
“Anyway You Can: Doctor Bosworth shares her mom’s cancer journey. A Beginners Guide to Ketones for Life”
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