Ketone and glucose levels both up

(Henry) #1

Hi everyone!

I’ve started a strict keto diet 10 days ago which is a followup on a 3 week period of gradually lowering carbs in my diet.

I do not have diabetes, allergies or any other sickness. I’m 5 10" (177cm) and weigh 154 pounds (70kg). My blood tests 10 days ago when I started my keto journey was:

Glucose: 4.2 mmol/L (75.6 mg/dL)
B-HbA1c (IFCC): 35 mmol/mol
Inflammation markers on a normal level

Question 1: On day 3 on the strict program I clocked a 4.2 mmol/L ketones in my blood. I measure blood at home. Since that I’ve constantly clocked 3+ levels with the 4.2 as the highest. Even in a fasted state, meaning before breakfast I clock 3+ levels. What does this mean? What I’ve read for most people even to get to a 1mmol/L state takes a lot longer. I strength train 5 times per week.

Question 2: This morning (12 hours without food) I tested my glucose levels as well as ketones and the numbers are 6.2 mmol/L (114 mmg/dL) and a 3.8 mmol/L ketones in my blood. Should I be concerned about the high glucose levels as I eat max 25grams of carbs per day? Also this would mean that I have a very high energy count in my blood (6.2+3.8) which is maybe not optimal for the benefits I’m looking for, like transforming my metabolism into a fat burner instead of a carb burner. Or maybe my glucose monitor is fooling me? I use menarini diagnostics monitor

http://www.menarinidiagnostics.com/Products/Home-Glucose-Testing/GlucoMen-LX2

Net carbs are around 20-25grams per day.

1 day meal example:

Breakfast: 2 eggs fried in coconut oil or butter and one avocado or just bulletproof coffee

Pre workout drink: Exogenous ketones (Prüvit Keto OS)

Lunch: Spinach, rucola, peppers, cucumber, ground beef or rib eye (grass fed), olive oil, and cabbage prepared in butter.

Dinner: basically same as lunch but meats and veggies vary

I take vitamin D, magnesium supplements

I do keto just because I like to experiment and for the positive benefits it can bring for mental and fat burning performance.

Lastly I feel totally normal, maybe even better than before with my high ketone levels but I just got worried about my glucose level.

Thankful for any insight you can give me!

(Allie) #2

6.2 isn’t high tbh.
Exogenous Ketones aren’t really necessary if your diet is on track, unless you just like peeing out your money.

(VLC.MD) #3

Stop testing your glucose levels ?

I can’t see what use the data would bring to your goal.

Feel free to convince me. I change my mind easily if I like better ideas.

(Todd Allen) #4

Early morning is when cortisol rises highest and cortisol raises blood glucose. 114 mg/dl fasting blood glucose is well into the pre-diabetic range (100-125) but if it only occurs in the morning it is less of an issue. If your are strength training elevated blood glucose, especially before bed, will blunt the growth hormone response reducing the muscle building effect of exercise. And chronically elevated blood glucose leads to hyperinsulinemia and insulin resistance. A loss of insulin receptors also blunts the anabolic effects of GH/IGF-1 as IGF-1 also relies on insulin receptors for some of its effect.

My guess is the exogenous ketones are the reason for your higher than typical blood ketones. It might also be contributing to elevated blood glucose and I’d stop taking them for a few days and see if your BG returns to your typical levels.

(Henry) #5

Thanks for the tip not wasting money :smiley: I’ll stop taking it from now on. 6.2 mmol/L -> 112 mg/dL glucose is in fact high in my opinion especially when there should be almost no carbs in my system to increase it. The whole idea of keto is to lower it and not the other way around right? All sites that I have researched state that higher than 6 mmol/L glucose is considered pre diabetic levels. It’s a pretty standard statement what I hear and read.

(Henry) #6

Thanks for the detailed response! I’ll stop taking them and reserve them maybe only to get back to ketosis if I fro some reason get kicked out of ketosis.

(Ethan) #7

Blockquote If your are strength training elevated blood glucose, especially before bed, will blunt the growth hormone response reducing the muscle building effect of exercise

Can you elaborate a bit on this? I do my weight lifting in the evening. Usually my blood sugars are lowest then, but they rise up overnight. I am not sure I understand what you are saying will happen.

(Todd Allen) #8

Growth hormone is one of several hormones that raise blood sugar level. The others, cortisol, norepinephrine and epinephrine do so acutely prompting the liver to release glycogen and are less inhibited by already elevated levels of blood sugar. GH does it more gradually by stimulating gluconeogenesis in the liver and kidneys and high blood sugar inhibits GH release.

Growth hormone normally peaks during the first hours of sleep when the other blood glucose raising hormones should be at their lowest levels and blood glucose should otherwise be falling stimulating GH release. It is also during this NREM sleep that neurotransmitters GABA and glycine block voluntary muscle signaling resulting in paralysis of skeletal muscle which is speculated to facilitate the GH stimulated processes growing muscle fibers.

The blood sugar raising effect of GH is also likely a significant contributor to the health problems encountered by athletes, especially body builders, who inject growth hormone. Elevating GH out of context with the body’s natural regulatory cycles can lead to high blood sugar and the cascade of problems such as hyperinsulinemia, cardio vascular disease and other problems seen with T2DM. My concern about exogenous ketones is that they also allow for a somewhat unnatural state. Normally ketones are only dramatically elevated in a state of energy deprivation, falling blood glucose with depleting glycogen stores. I don’t think it is well studied what happens when you dump in this extra fuel in a state where your body otherwise doesn’t need it.

(Ethan) #9

I agree with the assessment on exogenous ketones. If your body is able to make all the ketones it needs, there should never be a need for exogenous ketones. I could see them being valuable for keeping glucose-ketone ratios low (e.g., for potential anti-cancer benefits) or if a person has issues creating ketones.

I still don’t get whether you are making an assessment that working out at a particular time of day is good or bad.

(Todd Allen) #10

I wasn’t commenting at all on the time of day for working out.

The micro tears in the muscle fibers appear to be a significant contributor to the anabolic response and those take days to heal. My guess is that working out whenever you can achieve best intensity will likely give best results. Myself, I tend to be freshest in the morning but often am hesitant to put in my best effort then because I don’t want to be sore and flat the rest of the day. While it is more challenging for me to put in a great effort in the evening that is when I usually lift hardest without holding back because there is less of an issue for me getting deeply fatigued.

Also, I find if I work out in the morning I get hungry and eat a lot more later in the day while if I eat an early dinner and then work out when I start to feel a little hungry the hunger is suppressed while working out and I go to sleep before it kicks back in. And so long as I’m eating keto I’m not hungry in the morning regardless of whether I work out the previous evening.

(Allie) #11

If it’s consistent maybe worth looking at (though it’s only 0.2 higher than what’s considered normal) but not as a one off.

(Henry) #12

So if I understand your point correctly, me taking exogenous ketones gives me more energy than I need and therefore my blood glucose might stay high even if my carb intake is very low? Could the high energy intake in the form of ketones also increase gluconeogenesis in my liver then?

(Ethan) #13

Some say that it could increase insulin to stop the production of ketones. Increased insulin I suppose could mean increased GNG to keep sugar up.

(VLC.MD) #14

Doesn’t matter.

Your liver will make all the glucose your body needs.

IFCC 35 = A1c of 6.0
That’s pretty high for a 155 lbs

Keto for six months and the recheck your A1c and see if it improves.

(Henry) #15

Thanks for the recommendation. Still new to all that has to do with metabolism so “almost no carbs in my system” was clearly the wrong thing to state :wink:. According to the health standards in my country a “good” level of IFCC is between 27-42 so it’s definitely on the higher end than the lower but nothing I worried about when I got the results or am I missing something? 35 converted to DCCT (US) is 5.35 btw

Does weight have something to do with blood suger levels?

(Dawn Comber) #16

Hi @VLC.MD. A few times, I’ve read that ketoers should stop testing glucose levels. Can you help me to understand why you (and others) think it is not necessary or helpful?

(VLC.MD) #17

I’ve asked a few times what non-diabetics think they are gaining by glucose testing.
No one has replied.
I’m trying to learn why people are testing !

I see value in ketone testing.

Other posters think they have diabetes with an A1c of 4.x and a morning glucose that is all dawn phenomena.

I’m all ears !

(Ethan) #18

The value in testing is to see a reaction to a particular food. For example, if I suspect a certain restaurant may be keto-friendly, but I want to be sure, I will eat there and test blood glucose at 0 minutes, 30, minutes, 60 minutes, and 90 minutes after eating. If the readings went way up anytime over the baseline, I will determine there was a level of carb in the food. In either case, I will test ketones 0 hours, 4 hours, and 12 hours after eating. If the ketone level at 4 hours has dropped a lot, there was at least some insulin effect. If the ketone level after 12 hours is below 0.5, then it had a significant insulin effect, and I must never eat that food again.

EDIT: While I am diabetic, I would say a non-diabetic person can implement the same protocols.

(Dawn Comber) #19

By Diabetes Association definitions, I am non-diabetic although I am in the pre-diabetic range. Other doctors (Bernstein for one) would consider my levels in the diabetic range. So which standards should you go by?

I have read that elevated blood sugars - even in the mid to high 5s - cause damage to your cells. I test for 2 reasons.

  • I want to know whether the low carb/ketogenic way of eating addresses/is lowering my glucose levels to where I think they should be
  • I want to know the impact of certain foods on my blood sugars to - as @EZB said.
  • I am trying to figure out whether I need more than just dietary tweaks to lower blood sugars
(VLC.MD) #20

Correct you are ! The A1c of 5.35 makes more sense anyway. 6.0 seemed high for you.
image
https://www.diabetes.co.uk/hba1c-units-converter.html

Thanks !