Ketone levels consistently above 3.0

#1

Hi all,

I use a blood Ketone reader on a semi-daily basis to keep an eye on my levels.

I have been getting readings in the 3.0-to 4.5 millomar range frequently for the past few weeks. I’m doing a pretty strict keto diet so I’m happy to see that I’m in ketosis. However I want to make sure I don’t do any harm and lose muscle mass. I’ve read in multiple places that if your’e going above 3.0 that means you are starving yourself. Is this always accurate or is it different for some people? I’ve had readings above 3.0 where I wasn’t even hungry. Is it possible to have such levels without under-eating and slowing your metabolism?

I love the keto diet because it helped me lose a lot of body fat. Right now I am at about 15% body fat (I’m a 30 year old male). But for the past few months I’ve hit a wall and I’m seeing extremely slow progress. I’m hoping that going deeper into ketosis can get me below 10% at some point. Is it safe though?

(You've tried everything else; why not try bacon?) #2

No, it’s different for everyone. Some people never show a blood ketone number above 0.5 and would kill to have a number as high as yours. When you eat a low-carb/keto diet, your blood ketone number depends partly on how much protein you are getting, but it’s complicated. Furthermore, we have no idea how much β-hydroxybutyrate we are actually making or actually using. All the serum β-hydroxybutyrate level tells us is how much we haven’t used yet.

The real concern is a state called ketoacidosis, but your ketone level is not nearly high enough for that, and furthermore, if your body is making any insulin at all, ketoacidosis is not, generally speaking, a concern. (They have recently found a couple of cases of non-diabetic ketoacidosis in people who were taking certain prescription drugs, but your ketone numbers would still have to be a lot higher for you to have ketoacidosis, even if you were taking one of those drugs.)

What is really happening to you is that weight loss always slows as we approach our ideal weight. The level of β-hydroxybutyrate in our blood is not a factor in this process.

As for the idea that a β-hydroxybutyrate level above 3.0 means that you’re starving, I’ve never heard such a thing. I suspect that whoever told you that got something garbled, because it is true that people often show a higher ketone level while fasting, sometimes quite a high one. I can see how that idea might easily get garbled in transmission.

So relax and KCKO. You’re doing fine.

#3

Thanks for clarifying.

If you google “ketone range” or something similar and it’s the first thing that comes up:

“The acceptable range for blood ketones is less than 0.6 mmol/L. Between 0.6 and 1.5 mmol/L Recheck blood glucose and ketones in 2-4 hours. Between 1.5 and 3.0 mmol/L May be at risk for developing ketoacidosis. More than 3.0 mmol/L Requires immediate emergency treatment.”

So I’m sure I’m not the only one that heard it. It’s sad how much bad information there is out there.

(Robert C) #4

I think “starving” is the wrong word here (fasting is the right word).

I get above 3.0 on my second or third day of fasting - going up around 6.0 on longer fasts (otherwise I hang around 0.8 to 2.2 on just keto).

Fasting increases growth hormone - exactly the opposite of losing muscle mass - with workouts it gives you the potential to increase it.

(You've tried everything else; why not try bacon?) #5

Ah, well that explains that! That is carb-based crap. Your ketone level doesn’t by itself necessarily make you acidotic, because there are a number of other factors that help regulate blood pH. The likeliest factor to change is the absence of insulin, and with certain specific exceptions, if there is insulin in your blood stream, you will not become ketoacidotic even at fairly high ketone levels. Here is Phinney’s and Volek’s chart of ketone levels, to help clarify matters:
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