Feels like I should be in Ketosis, but aren't?!

#1

I’ve been on a keto plan for 30 days.
Measured macros all but 2 days in mfp (just lazy, not cheating)
I am trying to figure out what is going on.

Week 1: 12%, 25%, 63% (total carbs, protein, fat)
Week 2: 8%, 26%, 66%
Week 3: 9% 24%, 67%
Week 4: 8%, 21%, 71%
Week 5: 9%, 24%, 67% (so far)
Average calories approx 1,550-1,600 per day.
I do not back out Fiber.

I am doing minimum exercise. A couple days of swimming (medium), a couple days of light exercise on bike and kettlebell swings, a bunch of walks, etc. I am at a desk job.

I felt a bit bad for a few days at the start. I have what seems to be keto breath and taste in my mouth starting about 1 week in.

I am a type 1 diabetic with insulin resistance before starting.
My BG is tested every 5 minutes, here are the averages with standard deviations ~15mg/dl (ie no wild swings)
Week 1: 108 mg/dl avg
Week 2: 92
Week 3: 94
Week 4: 93
Week 5: 102 so far
My insulin intake has dropped by approx 65-70%

My weight loss
Week 1: 8.3 lbs
Week 2: 0.7 lbs
Week 3: 2.9 lbs
Week 4: 0.8 lbs
Week 5: 0.6 lbs (so far)
Started at 189.2 and currently and 175.9
Target weight = 170.0

I had not tested Keytones at all until day 29 (yesterday).
I now have a red Ketonix that measures in PPM

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Other notes:

  • I have done the “slow carb” diet 4-5x in the past with stints of 2-3 months each. I did not think any of those diets put me in Ketosis, but it may be possible i was fat adapted (i kinda doubt it. I was around 50g of carbs but had more protein and considerably less fat).

Some days I have been drinking a small Cappuccino (Aussie version), besides that I do not ingest any carbs besides incidental from greens, etc.

I am a bit baffled to why my keytones are so low. In fact i just tested an hour after eating 32g of mac nuts and now blowing a zero.

Any ideas on what is going on? In general happy with my progres, but…
I am really shocked that i am not in at least nutritional ketosis.

What is going on?

#2

Macronutrients are shown as percentages, but macronutrients in grams is more helpful since it’s generally recognized that carbohydrate grams need to be at or below 20 grams to be safely considered ketogenic and protein shouldn’t be above 1.5 grams per kilogram of lean body mass, so it is possible that these percentages represent a more Atkins-style low-carb, higher than moderate protein, and some fat. I’m not saying that is true, just pointing out the possibility and confusion resulting from reporting macros as percentages instead absolute gram weights.

Bear in mind that Dr. Stephen Phinney and Dr. Jeff Volek defined “nutritional ketosis” (NK) by looking at blood ketone (BK) levels of people who were not fat-adapted and eating substantial quantities of carbs and those that were eating very low-carb (VLC) and made a determination that NK would be BK levels above 0.5 mM/dL.

Anecdotally we’ve seen evidence that BK only reflects the ketones on their way to be used and we’re not measuring the ketones actually being utilized for fuel in the cells, so there is room for a disparity between what’s being created by the liver and what’s being burned and what we can measure in the blood at any one time.

This is confounded by the fact that ketosis is being evaluated using a breath meter (I have nothing against the Ketonix) which is only measuring acetone and even the inventor has reported that many people don’t use it correctly and aren’t expelling the air in the deepest part of the lungs where the acetone really accumulates. In the podcast below, the inventor offers an example of one user who wasn’t registering NK and after some brief instruction was blowing much higher levels of acetone.

http://www.thelivinlowcarbshow.com/shownotes/15620/1210-michel-lundell-and-alison-gannette-low-carb-vail/

If you’re otherwise seeing benefits from eating low-carb, high-fat and moderate protein and don’t necessarily see that reflected in blood/breath ketone levels, I think there’s enough margin for error in the testing process that you can safely assume the levels you’re seeing are adequate for you, but you can also use these results to make adjustments such as reducing protein and eating more fat to see how they impact test results.

#3

Thanks for the reply!

I actually calculate all the marcros every which way, below is the listed in the formats you mentioned.

I think I am very close to the suggested limits you have mentioned. I don’t have much of a standard deviation day to day so the average are very representative. I did try to move things around slightly from week to week to see if i could improve based upon the many different methods mentioned on optimisingnutrution.com and that I have learned as I go.

Averages (note my average lean bodyweight was 66.5kg (fluctuated 66-67 from my daily weighins which are just on a home scale but close enough for this calc)
Week 1: 41g Carbs, 32g Net Carbs, 81g Protein, 1.21g protein per lean bodymass kg
Week 2: 32g Carbs, 23g Net Carbs, 101g Protein, 1.52g protein per lean bodymass kg
Week 3: 32g Carbs, 22g Net Carbs, 98g Protein, 1.47g protein per lean bodymass kg
Week 4: 22g Carbs, 16g Net Carbs, 79g Protein, 1.19g protein per lean bodymass kg
Week 5: 26g Carbs, 16g Net Carbs, 84g Protein, 1.26g protein per lean bodymass kg

I am pretty sure i am using the Ketonix correctly. I ready the guide 3x and watch the demo video twice. I have tested all 3 settings on the unit itself and am positive I am blowing it all the way out.

Keep in mind too that I have BG values every 5 minutes 24/7 so I know exactly what foods actually move my BG or require insulin and how much. Outside of trying some peas to see what happened (it rose) I have almost no upward movement from anything including Protein (that is a subject for another post).

I guess next step is to fast and see if i can get it up.

#4

I am also curious about those Max macro numbers you referenced and how they work with Plinney’s other model… the 4 stages model.

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https://optimisingnutrition.files.wordpress.com/2015/08/image008.png

It seems to me like with my stats…
MBF+ medlow exercise says total calories burned 2,164

Using stage 2
0.6923076923 Lose some % of MBR including exercise
1,500 calories suggested from food, the rest coming from stored body fat
7% carbs, 20% protein, 40% fat, 33% stored fat
Those ratios after pulling out stored fat is
10.45% Carbs
29.85% Protein
59.70% Fat

at 1500 calories eaten per this model then the grams would be
38g of Carbs
112g of Protein
100g of Fat

It seems to me like either i am doing the math wrong or something does not add up with the different Plinney models.

#5

In case anyone is following along…

I completed a 25 hour fast lasting from 6:30pm to 7:30pm. At the end of the fast I started blowing 10+ into the Ketonix. I had about 1,250 calories between 7:30 and 10pm and stuck with my usual meat + green veggies + snacks of cheddar cheese and mac nuts. I maintained levels between 10 and 14 overnight and this morning. They stuck through my normal breakfast (eggs and bacon) and some lunch and more cheese. Then I decided to test my luck with the coffee that I have been having most days (contains some full cream milk). I immediately dropped down to 3 ppm. So, I think I have found the culprit that keeps me down.

The question now is how long will I stay at this level and do i need to fast again to get my levels back up (and if so for how long). Time for some more n=1

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#6

If you are in stage 2, does that mean you are consuming 45 grams carbs per day?

#7

I think weight wise that is where I should be. To me that math says 10.45% of 1500 calories as carbs, so 38g of carbs.

I have not converted to that system really though. This week is week 5 above, 26g carbs or 16g net carbs. I was planning to and started to migrate to stage 2 a day or two before the Ketonix arrived at my doorstep, but stopped until I can sort it out.

I am kinda assuming if i am not actually in ketosis then the gates aren’t open enough to burn 664 calories from fat, or at least not all of it. So i guess that actually puts me on calorie restriction?

#8

My advice, in general, would be to take a strep back from calories and percentages and deal with grams directly. And eliminate the milk in favor of cream.

#9

Thanks. I mostly get to the evenings and check my total grams and make sure i don’t go over, so all good there. Is under 20g of carbs total or net? I am perplexed by the chart I attached above. Guess I will just ignore it for now.

I just cut out the milk and am going with espresso for now. May switch that up if i need more fat later. It has been 60 hours since that coffee but I did finally blow a 4.1ppm in my ketonix tonight which finally puts me at the bottom end of Nutritional Ketosis.

#10

This is something that varies according to each person because there are so many different opinions on what carbs can or cannot be ignored when determining net carbs which is why the general advise is to count total carbs until you know what you can personally exclude.

I know that although I could be in ketosis by ignoring certain carbs, I feel better staying under 20 total carbs.

#11

Thanks.

I find that for my T1D i can not subtract off fiber, but it’s tough staying under 20 carbs without going net. Just incidental carbs from veggies and mac nuts put me at 22 total today. But since I am hitting the low end of ketosis I guess i can probably use net.

Thanks again! (no need to reply)