Hello and thank you letting me to become a member. I’m not new to keto, this is my third attempt. Each time I start I feel that I know just that little more and feel more prepared. I started in February and pretty much got in to ketosis within 48 hours. Since then I have consistently maintained high to moderate levels. This time round I started to incorporate intermittent fasting. Started with 16:8, this last week I have managed with success 24 hours fasts. I have been monitoring my glucose, ketones and Gki closely at least twice or three times daily since I started. I’m interested in my metabolic health and how certain foods affect my glucose levels. I’m not diabetic. Since I started 23 hour fasts my gki is 0.7-1 I’m doing lots of research in to this as I thought it’s very unlikely to achieve without foctors supervision. I feel fine and drink plenty of water. For example. Just before I broke my fast today my glucose was 3.6 mmols, ketones 5.6 mmols gki 0.7. The day before gki was 0.9 mmols. I must say this is the lowest I been. I have been doing pretty clean keto no cheating or artificial sweeteners. Can anyone advice me on this. Is it safe to continue. I feel fine even if my blood glucose drops but may have a headache if I need more water. I’m currently doing omad or 20:4 My concern is that Im probably not getting enough food. Please let me know what you think of these GKI I am pleased but I didn’t think it would be this easy for me. Thank you.
Gki
It sounds as though you are doing fine. Be sure to eat enough; as long as you are keeping carbs low, your body can shed excess fat and speed up your metabolism, so calories are not the concern they are on the standard diet (which is really the sort of diet a bear eats to put on fat for the winter, when you get right down to it).
I wouldn’t worry too much about numbers at the moment. Low serum glucose is the goal. If you have ketones to feed your brain, you won’t get hypoglycaemic. A study done in the 1960’s by George Cahill and his team showed that they could drive people’s serum glucose down to around 2.2 without ill effects, so long as there were ketones to take up the slack.
The brain does need a small amount of glucose, and your red blood cells live on glucose, but the liver is perfectly capable of making the small amount of glucose needed, even if you don’t eat any carbohydrate at all.
As for headaches, they are related not only to staying hydrated, but to getting enough salt. It is safe to eat a bit more salt than you are used to eating, and it should help stave off the headaches. The mechanism is complicated, but it involves the interaction of insulin, your kidneys, and something called the renin-aldosterone-angiotensin pathway. As long as you get enough salt and drink to thirst (so as to avoid becoming either under- or over-hydrated), you’ll be fine.
I tend to get migraine auras if I don’t eat enough salt, and I find that if an aura starts, I am usually fine within minutes if I sprinkle salt in the palm of my hand and eat it. Otherwise, I’m down for between half an hour and an hour, and for the rest of the day, if a full-blown migraine develops. Too much salt, on the other hand, gives me diarrhoea (again, because of that renin-aldosterone-angiotensin pathway), so my body’s reactions tell me where the sweet spot is, lol!
So just keep calm and keto on!
Thank you so much for such a comprehensive reply!!! I been trying to research low blood sugars as I’m a nurse and it’s totally different than what I learned in the nursing school years ago. So I’ll just continue as I am as I feel good. Most of the times and I will include little more salt as that could be the culprit behind my headaches. Again thank you.
It’s true that people on a high-carb diet are vulnerable to hypoglycaemia at a higher level of serum glucose than people on a low-carb, high-fat, ketogenic diet. The difference is the presence of ketones in the latter group, since ketone bodies are an alternative fuel for the brain.
You were probably taught about ketones in the context of diabetic ketoacidosis, in which ketone production in the liver and serum glucose are both out of control, because of the lack of insulin. But if the pancreas can still produce any insulin at all, diabetic ketoacidosis is not a concern.
Cahill’s work was done on fasting subjects, and therefore their serum ketone levels were elevated. So the effect of the euglycaemic hyperinsulinaemic clamp applied to them was simply to switch their brains from metabolising glucose to metabolising ketones. That is why the subjects were fine at glucose levels that would normally result in coma or death. There are even data to support the belief that the brain actually prefers ketones, when it can get them.
Of course, Cahill’s experiment was unethical, even back in the day, and no such thing would be tolerated today by any institutional review board in its right mind, but they did learn something useful, though you have to read Cahill’s work, Starvation in Man, rather carefully to find their report of the results. (As Stephen Phinney, who knew Cahill, likes to joke, the people with the palpitations and sweating were the ones in the lab coats.)
Interestingly, Cahill still concluded that the brain requires 130 g of glucose/day, even despite his experience with euglycaemic hyperinsulinaemic clamps, and this figure has become standard teaching. We now know, hoever, that the human race is unusual among mammals in routinely entering a state of ketosis very easily. In every other mammal, elevated ketones are seen only in the late stages of starvation. We also know that brain cells require insulin in order to be able to absorb glucose, and that errors in brain glucose metabolism, or glycative damage to mitochondria in brain cells, can lead to dementia, motor-neuron disease, and mental health problems. We also know that elevated serum ketones can help greatly to mitigate the symptoms of these conditions, because ketone bodies are assimilated into the brain by separate receptors. (Of course, ketosis is not a panacaea, but it can help significantly.) Some researchers have actually taken to calling Alzheimer’s dementia Type III diabetes, in order to emphasise this connection with poor glucose metabolism in the brain. (It’s a poor name, for a number of reasons, but they do have a point.)
We also know a lot more about the effects of insulin and glucagon on the body than we did, thanks to the work of Yalow and Berson on their radioimmunoassay. Unfortunately, a lot of thinking about insulin and glucose and diabetes was worked out before the discovery of insulin in 1921, and subsequent thinking was distorted by our inability to measure serum insulin until the 1960’s. I’m amazed that they were able to get so much right, working in the dark, as they were.
Anyway, welcome to the forums, and I hope you will share your progress with us as you go along.
I just found this thread and wanted to chime in because I came across Glucose Ketone Index (GKI).
Is this an accurate way to know your ketone level? If I am understanding, you just take your BG, and divide by 18 to get your Blood Ketone Result?
Thanks for starting the thread @Mon1 as I would like to have an idea of what my ketone level is and not having to buy some gadget to figure out at least a ball-park figure would be great!
Hello and thank you for your reply. I been testing my ketones and glucose for some time. For me it gives me accountability. I have keto mojo using two different strips. One for ketones and one for glucose. Because I’m in the uk my monitor is set to mmols for both ketones and glucose. I know that in the USA it’s mg/dl for glucose so measuring Gki would be little different.
- Measure your blood glucose levels as described with your monitor
- Then, do the same for your ketone levels.
- Note the results.
- Then, use this formula: [Blood Glucose Result ÷ 18] ÷ Blood Ketone Result = Gki
I found this very informative website regarding glucose and ketone monitoring and it also explains Gki very well. I’m not promoting programme just an article and Hope it’s allowed. As I recently started fasting I like to see what is happening in my metabolic health. I’m trying to achieve autophagy. This is the link to the website
https://thinlicious.com/glucose-and-ketone-testing-101/#:~:text=Your%20glucose%20ketone%20index%2C%20or,both%20glucose%20and%20ketone%20readings.
If I can be of any help let me know. I am still learning myself though.
So it’s glucose result divided by 18, but then you have to also test the Ketone Result divided by 18? I’m confused a little. How do I get the final number?
If your glucose meter is set to mg/dl you need to divide that by 18 to get your glucose level in mmols. Ketone level is measured separately so that wil be completely different number and you would need a ketone testing strip. Once you have your glucose and ketone results you need to. Glucose divide ketones =gki. On keto mojo website is a calculator and you just add your numbers. I got keto mojo dual monitor and find it very good but it’s bit pricey. Some people don’t test at all as there are other ways to know you are in ketosis but I like to know my levels at the moment as I’m still adapting to new lifestyle.
Thank you Mon, ok this makes more sense to me now and my brain is on the foggy side 
I was just looking at the Mojo. I take it the dual monitor is for Glucose and Ketones? I’ll check out the price, although I have pretty good BG monitor already, a Caretouch. I’ll weigh out the prices, including more strips, lancets and see what I can find!
Thank you again, and the calculator on the Mojo site sounds great, I’ll take a look at that also.
I know I don’t “need” to know ketone levels, even ballpark, but like you, I think it will be fun and maybe informative if I might be further off than I think Denise
My experience with GKI is that mine is always bad. I no longer produce the ketones I used to (<0.5 mmol/l is common for me) and my morning blood sugar is higher. I’ve taken to basically ignoring GKI.
Hi Bob I am experiencing similar even after 24 hour fast. I am extending my fast today to see if it makes any difference.
If you’re keto a longer time, you’ll get lower ketones (in general). And some people get lower ketones anyway.
Fasting does help “raise” my ketones, but I have a cycle where I have lower ketones/higher blood sugar in the morning, higher ketones/lower blood sugar at night. The best comparison for me is at night.
Now, this is only based on pin-prick meters. Europe has new continuous ketone meters, and the graphs I’ve seen from people using those are startling in terms of how much ketones are changing.