Ketone levels all over the place

(J) #1

I’m trying to figure out what am I doing wrong… I started Keto back in January. I stay under 20g of carbs a day. Eat avacado, eggs, MCT Oil, Bullet Proof coffee and a Naked Keto fat Bomb almost exclusively and I am not seeing much results. I have a macro tracker and make sure I’m keeping my fats higher than protein and carbs under 20g a day. I was using urine sticks and was really tired of inconsistent results so got a blood ketone meter about 3-4 weeks ago. I test several times a day and the results have been driving me nuts. On average I’m only getting 0.3 readings, sometimes in the later afternoons 0.5-0.6. ONE day I got 1.5. I just tested this morning after no change in diet and it was 0.2. What SHOULD I be getting if Keto is working? I’ve read starting at 0.5 but I’m almost always at 0.3. I hope this all makes sense, I’m at my wits end and about to say screw it.

(Bill) #2

If you are registering ketones you are in ketosis… period.

Like blood sugar blood ketones levels are pretty variable… revel in the knowledge that you are doing great.


Think of it this way. The energy your body requires to function and keep you alive can come from only two sources: carbs or fat. If you cut out the carbs then the remaining option is fat. When fat is metabolized ketones are generated only when the fat available exceeds your liver’s ability to oxidize it. In that specific situation, your liver generates ketones rather than just dump the excess fat.

Don’t chase ketones. They come and go. They take care of themselves. In fact, I think it’s very unfortunate that we even talk about eating a ‘ketogenic diet’ simply because it seems to cause so many folks so much anxiety trying to measure their ketones. What matters is don’t eat carbs. Period.

Best wishes.

(J) #4

Thank you for your reply. I guess that’s where I’m having the biggest issue. I was initially under the impression that if I’m seeing ketones I am in ketosis but I keep reading article after article that say ”As long as your ketones are registering 0.5 mmol/L or higher, your body is still being programmed to burn fat and stay in ketosis!* but my levels are normally around 0.3-0.4 and peak at 0.5 much later in the day if at all. If I was seeing consistent weight loss I wouldn’t care but I’m not really seeing much weight loss.

(Bill) #5

Volek and Phinney have a lot to answer for with their stupid graphic…

maybe try some fasting if you want to increase your levels…

(J) #6

I do daily 16/8 intermittent fasting and sometimes one meal a day. I just want to see some damn results lol. I’m trying to get down to a healthier weight which I feel I can maintain once there but thought after 2 months I’d at least see some better results that I’m seeing.


Keep your total carbs sub-20 grams per day, and the lower the better. If you do so, your metabolism is burning fat and will move your overall health in the right direction. Remind yourself as often as you need to that you’ve been damaged by years/decades eating SAD. The most important thing to you might be your desire to lose some weight/fat, but to your metabolism other stuff might be more important and need to be fixed first. Losing weight/fat on a ketogenic diet is not necessarily a linear process, sometimes other stuff takes precedence. Stay consistent and stay consistently in ketosis by eating little or no carbs. You’ll be OK.

(Joey) #8

Welcome to the forum! As others have noted, it sounds like you’re doing every right to changeover your metabolism for the better. Congratulations for your diligence and perseverance.

It might help if you also share a few more details that might be at play for the slower start than you’d anticipated …

How significantly overweight are you?
Do you have any signs of insulin resistance (pre-diabetes, fairly high glucose levels)?
Tossing the urine sticks was a wise move. Since you’re measuring serum ketones, are you also measuring glucose while you’re at it? What might that betelling you?
Otherwise, how’s your sleep and stress level been?
Are you feeling any different since cutting out the carbs… any other noticeable changes?

Don’t mean to hit you with an inquisition, just trying to see if some other variables might be at play.


(J) #9

Hello and thank you! I’m currently 290 lbs (started at around 300 In January) 44 year old male. unfortunately I only got a ketone blood meter didn’t even know there was a unit that does both gluclose and ketones. I did keto about a year and a half maybe two years ago and lost about 30 lbs or so but gave into lifestyle and temptation and went back to eating horribly. Recently the last two times I drank I actually blacked out which upon researching possible causes led me to maybe I’m diabetic (not sure yet have my first physical in 3+ years scheduled in a few weeks) went back to keto as it’s easier for me diet wise and the only thing that seems to help keep me strict and off the carbs. Stress level is relatively low, though I do have two young children 8 and 5 that come with stress automatically. I work From home as a sound designer so low stress, lots of happiness and calm from my job. Sleep is decent, I’ve always been a bad sleeper but recently started wearing ear plugs which has helped me sleep a little better. The only real exercise I get is walking my kids to school every day and playing fairly fast, aggressive drums when I can. I’m fairly used to fasting at this point, been doing intermittent fasting off and on for years and have very low sugar/carb cravings. I feel good, energy level wise.

(Robin) #10

Welcome! Glad you made your way here. You are on the path already, now you just need to hold steady and let your body adjust and tell you what works or doesn’t.
Wondering if alcohol is playing a role? but, I am a recovered alcoholic so I tend to have my antennae up for that.
Also, are you getting enough calories? Keto is not the time to restrict calories, in fact you can probably eat moe than before.

But whatever… 10 pounds in 2-3 months is nothing to be sad about. A small movement can set you on an entirely new trajectory. You got this!

(Chuck) #11

What results are you looking for? I do even attempt to measure ketones, my measurements are my health, energy level, body measurements and lastly weight. At 75 I am so much more healthy, I have energy to spare, my body is slimming down almost daily, and I am slowly losing weight. I am down 35 pounds since the first of September. And I almost for to say that I am off all prescription medication for the first time since I was 29 years old.
I keep my total carbs below 75 now, and my fat and protein intake varies greatly depending on my appetite and what my wife cooks. I am not and never have been diabetic. My lab results are okay. I don’t eat eggs everyday so my cholesterol isn’t high in fact it was low when I started the low carb lifestyle a little over 5 months ago. I am going to say this stop stressing because that just makes things worse. Look for results in other places other than ketones.

(J) #12

Thank you. I do not really drink any more. Since having kids I mostly stopped partying all together but we go to the desert several times a year. The last two times i drank in a party atmosphere I ended up blacking out which has never happened to me before. Both took place within the same year or so. I normally could drink most people under the table any day of the week and drank quite a bit quite often. Having kids changed all that for me. No more rockstar lifestyle for me. Now I’m trying to get my health In order so I can be around for them. I have a keto app that I use to track my food and I eat around 1800-2300 calories a day.


Ketone levels don’t matter, only that they’re there. Don’t waste your time or energy caring about them.

Which isn’t necessary, and having low protein isn’t doing you any favors. Neither is eating tons of fat for no reason at all. If it’s part of your meal thats one thing, don’t put it in there for the sake of doing it.

I lost over 100lbs almost never going above 0.3,

“Nutritional” Ketosis is make believe, if you show blood ketones, you’re in Ketosis.

Keep your carbs down, let keto do it’s thing. Don’t complicate simple, don’t over-science stuff. Then you get your results and you get to keep your sanity.

(Robin) #14

Sounds good! You’ve already done most of the hard work. Hang in there!

(J) #15

Thank you. I’m going to stick with it unless my labs come back really bad. I am a cocktail of bad genes as well. High blood pressure, high cholesterol, heart disease , you name it. Dad died of a stroke at 63, Moms Dad died of a heart attack at 50 and lots of other strokes and heart attacks on both sides of the family so I’m not going to lie, Keto has me a little nervous. Honestly I just want to keep off the carbs and keto seems to be the only thing that keeps me accountable and the “consequence” of getting out of ketosis isn’t worth it (at least mentally)

(Joey) #16

@Chino2012 Thank you for sharing the additional background info.

Yes, your family history suggests that you will want to be extra diligent in taking good care of yourself to avoid similar outcomes - all the more so given those little kids depending on you to help diaper future grandchildren.

I wouldn’t peg too much on “the labs” when they come back. They may well show that your LDL is super high (by lab reference ranges) and perhaps other metrics that are not currently in the normal range.

The one I’d be most focused on is the HbA1c /glucose levels, along with your HDL/triglyceride relationship. Of course, the long term solution to any of these biomarkers that not in the “healthy” range would be to do EXACTLY what you’re now finally doing for yourself … i.e., cutting out the carbs and the black-out booze drinking.

You and your family deserve your best health. Along the way, ketone levels and weight loss will do whatever they’re going to do.

Onward, friend! :vulcan_salute:

(Bacon is a many-splendoured thing) #17

If you are not losing excess fat, then consider how much you are eating. A well-formulated ketogenic diet consists of strictly limited carbohydrate, adequate but not excessive protein, and enough fat added to satisfy hunger. The body adjusts its metabolism to match the amount of calories we give it, and many forum members have found that their fat loss didn’t begin until they started eating more, not less.

The point of measuring ketones is simply to verify that the body is in a state in which fatty-acid metabolism is prioritised over glucose metabolism. That depends on keeping insulin mostly below a certain threshold (just under 25 μU/mL) by keeping carbohydrate, and hence serum glucose, minimal.

(Bacon is a many-splendoured thing) #18

Keto is like showering: stop doing either, and the benefits of doing it go away.

As far as drinking to blackout is concerned, if it happened after you went keto, then you are discovering that alcohol hits a lot harder on a low-carb/keto diet, so moderate your intake. If it was before you went keto, then consider that you are an alcoholic and get treatment (A.A. works well for a lot of people, and it’s free). Normal drinkers mostly don’t drink, and they certainly never drink to blackout.


I have found that keeping my protein higher than my fat was/is more effective for my weight loss. My body slows down on taking fat from my body if it already has enough or too much fat from what I eat.

Perhaps try that instead of keeping fats higher than protein.

I wouldn’t worry too much about ketones. Keep your carbs at or below 20g net carbs and you are in ketosis. In fact, I’d say lock the ketone meter away for now.

(J) #20

@PaulL, thank you for the comment. I used to drink quite a lot and then mostly stopped or at least completely slowed down to maybe a beer a week if that after I became a father. I rarely drink but the two times I did, I did drink in excess and I was not doing keto. My concern was that when I was a regular drinker I could pretty much drink as much as I wanted without memory loss or any other symptoms aside from the occasional hangover. The two times aforementioned that I did black out made zero sense. I didn’t drink that much (comparatively) and didn’t understand why I blacked out. After spending some time trying to research why, I came to two conclusions. 1, that I might have consumed way more alcohol than I was aware of in a very short period of time or that 2, I might be diabetic. Either way, Dr appt was made and because it was so far out (2 months at the time of making the appt) I decided to go back to one thing that worked for me. While alcoholism does run pretty rampant in my family, drinking is not really a priority for me and I’ve always been able to immediately cut it off and go dry as soon as I want to or need to.