Elevated Fasting Blood Glucose

#1

I’ve been ketoing now almost 5 weeks but have been struggling to get my fasting blood glucose down. This morning my blood ketones registered at .8 but my blood glucose was 122. I’m eating about 90-100g protein a day but I weigh 217. Is it still just too much protein? Carb intake is negligible. Fat intake is probably 250g a day. Any thoughts? Thanks.

#2

For your weight, that does not seem like a lot of protein to me. I weigh 145, and I’ve calculated my minimum protein at 60g and can go as high as 100g.

As to blood glucose, there’s a phenomenon with ketosis where fasting BG is elevated, but it is benign. Peter at Hyperlipid had a post on his blog some time ago that provided the science behind this, but I could not follow it. This may be what you’re experiencing.

My endo told me that this is true, and he goes by my A1C rather than my fasting because of this.

#3

Protein could be lower if you are female (sorry, can’t tell) and/or not exercising, but the ketone level indicates you are accessing some fat overnight.

Have you taken glucose readings at night or before your main meal? Are they lower? You may be experiencing “dawn phenomenon” where glucose is higher in the morning because 1.) the same hormones that wake you up also give you some extra glucose to start the day or 2.) your glucose dropped overnight and your body reacts by making more of it. Also, if you happen to get up in the middle of the night, you could see what your glucose is doing before your normal waking time.

#4

I believe you are talking about physiological insulin resistance (PIR) also called glucose sparing. I’ve usually heard of it associated with people who have been ketogenic long term, and is thought to be an indicator of lower A1C and insulin levels. Physiological Insulin Resistance

#5

I am a male and have a job that keeps me walking all day long and moving boxes and such. I would’ve figured my protein isn’t too high. Right before dinner last night my ketones were 1.4 and blood glucose was 85 and that was 4 hours after lunch. Should I just continue what I’m doing and see what happens over the long term or keep dropping protein to see if it comes down?

#6

Those pre-meal numbers look great! I’d say your protein level is fine and it’s just an early morning spike in glucose.
An A1C test might be a good way to see your long term (3 month) average glucose. You’re only about halfway into that window at 5 weeks.

#7

Gotcha. Yeah, I felt great too at that time, but I wake up pretty groggy and foggy so I kind of feel like those fasting glucose numbers are a problem but maybe it will balance out? I’ll keep going as is, maybe drop my protein a little lower for a few days to see if I feel better? The other problem is I am a weightlifter, injured though so not able to workout at all right now, so I’m afraid if I cut my protein down too low I might lose muscle mass, correct?

#8

Any muscle loss would be because you aren’t working out rather than a slight decrease in protein. And most of that will be glycogen related rather than breaking down muscle fibers. Your body will preferentially use fat for fuel once you’re adapted. If you went super low on protein for a short time, as part of your experiment, the first proteins your body would use are the old misformed ones that need to be cleared out.
Once you start working out again, you can adjust back up to your needs.

#9

Well, maybe I’ll drop that low to aid in potential injury recovery then. Thanks.

#10

Something else I don’t understand, and maybe it’s the same and no problem…
My blood sugar right now (lunch at 12:45, and breakfast was at 6:30) is 116 and ketones are now .9. So ketones and blood glucose are about the same 6 hours after breakfast as they were when fasted this morning. I’ve been working and walking all morning, so I would’ve figured I would burned up some glucose but I guess not. My breakfast was less than 20g protein and 2 net carbs (4 total), and 50g fat. That’s the perfect keto meal isn’t it? What am I missing?

#11

The amount of exercise you’re getting at work may be keeping the glucose elevated too. There’s about a 2 hour window after exercise where you’ll see strange increases like that. The breakfast you described should have been digested and have minimal influence on your numbers after 6 hours unless you are extremely insulin resistant.

Oh yeah and stress, and poor sleep. Cortisol is not your friend when it comes to glucose levels.

#12

Gotcha. Well, I did sleep poorly last night but these numbers have happened at work several times even with good sleep so I’m guessing it’s the exercise at work. Taking everything into account now, it seems like the recommendation is to drive on with the same plan and see what happens over the next 6 weeks until I can get a A1C at 3 months?

Also, I shouldn’t be insulin resistant at all, my morning glucose fasted was ~90 before starting keto.

#13

I really don’t know what’s going on with my blood glucose. Pre-dinner tonight my ketones were 1.1 and blood glucose was 111. I think that was 5 hours after lunch so blood sugar should’ve normalized. I wasn’t at work today so i wasn’t exercising or anything. Could it just take longer for 5 weeks for insulin sensitivity to work itself out? Or if I was eating too much protein before as of a few days ago, does it take longer than a couple days to show the change? Or maybe eating garbage quality meal from Walmart might have an effect on it? I’ve been eating leftover Walmart burgers for the past week. And the brain fog to go along with it all is terrible. Any thoughts?

#14

I have no idea what might be added to those. Are they something you prepared at home from the meat, or something they cooked?

The brain fog while you are in ketosis maybe points to needing more salt?

Have you noticed any weight loss or reduction in appetite yet? Maybe you are a slow adapter and aren’t efficient at accessing body fat or using ketones yet.

#15

They were frozen that I threw on the grill.

I’ll go up to 3G sea salt. I’ve just been mixing a half teaspoon in water twice a day and adding salt to food when I remember? Increase to 3/4 tsp twice a day and add salt to all meals?

I’ve lost plenty of fat so far and reduction in appetite for sure. But I’m pretty sure I’m not 100% keto adapted yet.

#16

Most recommendations for salt are 5-7g/day. I add some pink salt to all my water bottles, plus whatever for food.

#17

Wow, that’s a lot of salt lol.

My fasting readings were better today, 1.4 ketones and 100 blood glucose. But I only had maybe 60 grams protein, maybe less. If I have to continue that little of protein, this diet may not be sustainable for me. I’ll drive on for a while like this and see what happens.

#18

It’s the elevation in ketones that allows your brain to be happy with a lower glucose level. Have you tried boosting ketones a bit with some mct or coconut oil in the morning? I suspect you just aren’t producing enough ketones to drive the glucose down because you’re not fully adapted to using them yet.

#19

I was using Brain Octane quite a bit in the beginning but have stopped because I read about exogenous ketones preventing fat loss since the body doesn’t need to produce them if they are already present, so maybe MCTs could do this too. I’m also trying intermittent fasting now (skipping breakfast and eating late lunch) to enhance all the potential benefits. Maybe I should just be eating regular keto, no fasting yet, and include MCTs until I’m truly fat adapted?

(Todd Allen) #20

You might be able to do blood flow restriction training depending on the injury. Some find they can keep building muscle while injured using very low weights with BFR.