Ketone levels going down - difficulty to account for cardio?



Hello everyone! I hope you’re all doing great.

I am new to this forum so I thank you in advance for any reply. I started Keto on the 20th of March. Things have been going pretty well for now. I used urine strips and a blood ketone meter to measure the amount of ketones and my glucose levels. Since the blood meter arrived after a few days at the beginning I was measuring just with urine strips and I had levels around 5 mg/dL after 3 days and it gradually increased towards 15 mg/dL around the 5th, 6th day.

With regards to the ketone and glucose levels from the blood testing the results are the following:
25/03: Ketones 0.8 mmol/L and Glucose 3.6 mool/L or 66 mg/dL
26/03: Ketones 1.3 mool/L
27/03: Ketones 1.7 mool/L and Glucose 3.7 mool/L or 66 mg/dL
28/03: Ketones 2.4 mool/L and Glucose 3.6 mool/L or 66 mg/dL
29/03 Ketones 1.6 mool/L and Glucose 4.0 mool/L or 72 mg/dL
30/03 Ketones 1.2 mool/L and Glucose 4.0 mool/L or 72 mg/dL

I have always tested in the morning before eating. I am 5’7 foot tall (173cm) and I weight 128 pounds (58,3 kg). Until now my macros have been on average 7% carbs, 21% protein and 72% fat. I am eating around 1500 kcal a day so more or less max 26 grams of total carbs a day, 76 grams of protein and around 117 grams of fats.

The issue is that I don’t know how to account for my activity level. I don’t do strength training nor intense cardio and my lifestyle is pretty sedentary (office type of work). However, I walk everyday 3.5/4.5 miles (5-8km) for an hour or more, not at a brisk pace but neither slow (I’d say around 2.5/3 miles per hour). This confuses me with the amount of protein I should eat as if I understood well the amount of protein for a sedentary lifestyle is 0.8 per pound yet I don’t think I am truly completely sedentary.

Since the level of ketones in my blood is decreasing (although I read that is not necessarily a bad signal) perhaps I am doing something wrong or my macros are wrong? Maybe I am eating too much protein? or maybe something else? My goal is weight loss so I should eat less calories than I actually am as I my BMR is around 1600/1700 (or at least it was the last time I had a check up).

Other details that may help are that I eat a bit more than my actual hunger (trying to work on that) and I have episodes of insomnia (for example yesterday night I slept only a few hours and today I overslept) which I think if I’m not mistaken can have an impact.

Today I woke up weighting 1 pound more (0,5 kg) and I feel like it’s a bit of water retention which is also weird as I have experiencing no particular retention since I started which also made me think about my diet. In other words I am not concerned about the weight as I know it can fluctuate a lot day to day but just wondering if I am doing something wrong.

Thank you very much for reading it and for your time! All opinions are valuable and I would really appreciate your take.

(ANNE ) #2

Not sure your rationale for wanting to lose weight. You are in the lower range of weight for height.
Other health benefits, like clear thinking, normalised blood sugars, more energy etc, are great reasons for keto.
I have tried to add a link to ht/weight chart, but failed.
That said, we are all different shapes and dream sizes. But from my own personal opinion, encouraging your further weight loss would be unwise.
Best of luck with keto health gains.

(Bacon enough and time) #3

The easiest way to account for your energy expenditure is to eat to satiety. At first you will find yourself eating a fair amount of food, but at some point, as your insulin drops and stops blocking the leptin receptors in your hypothalamus, your appetite is likely to re-regulate itself at a level that will allow you to metabolise both the fat in your food, and some of your excess stored fat.

The keys are getting your carbohydrate intake at a low enough level to allow your insulin to drop back down to a healthy level (elevated insulin keeps fatty acids trapped in fat cells) and eating enough food to allow your body to feel safe dispensing with some of its reserves (eating too few calories puts the body in famine mode and makes it reluctant to risk losing its cushion).

(Joey) #4

@annef Welcome to the forum!

I, too, am unclear as to why it’s important to you to lose weight given your current “dimensions” … but assuming you don’t have any dysphoria issues, I’ll make an assumption that may (or may not!) be accurate: You are not happy with the way you look in the mirror :wink:

I’m also going to assume (again, barring dysphoria issues) that it’s your shape - not your weight. Is that correct?

To be clear, keto eating is a MUCH healthier way to take good care of your body than S.A.D. - and keeping your carbs way down while you become fat-adapted is key for this to happen - but if you’re not pleased with your “shape” then targeted, thoughtfully-planned exercise is going to make a more meaningful difference.

Cardio is not likely going to be the ideal way to address “shape” issues given that you are already a fairly lean person. Strength-training and muscle-building/toning exercises are really going to be the keys to changing the way you look.

And the irony is, when you do build muscle, you may very well weigh MORE than you do currently.

Could you share a bit more about your situation and whether any of this assuming on my part might resonate with you and your goals? :vulcan_salute:


Thank you very much for your reply! I also have insulin issues hence I think it is particularly applicable and useful to my case.


Hi Joey,
Thank you for your interest. I am quite happy of how I look in the mirror and I am indeed fairly lean :slight_smile: I think there is just a bit of room for improvement! I totally agree with weight not being the right indicator as lean mass weights a lot more and that a low number on the scale does not entail a toned body. I simply don’t have other measurement tools right now and the scale was the most readily available! I thank you for your advices though! My lack of physical exercise is due to the fact that I am required to spend 14/16 hours a day working and I have a difficult time to include exercise (I could wake up one hour early but I also need rest) in my daily routine. That’s why I walk so much: I manage to include it daily whilst doing other commissions!

Other conditions that I have are a slow thyroid, a microfollicular ovary and insulin resistance (diabetes runs in the family) so it’s not the best of situations actually…

(Michael - When reality fails to meet expectations, the problem is not reality.) #7

Don’t worry about ketones. Eat sub-20 grams of carbs per day, the fewer the better. Your metabolism will synthesize and utilize the ketones it needs and can use. This will fluctuate. Fluctuations in ketones are normal. I think BG is more important than measuring ketones and the numbers you posted above look very good, well within the normal range. Although we don’t have a home device to measure insulin, we can infer the rise and fall of insulin by observing the rise and fall of BG. For example, if a small rise in BG occurs after a meal followed 15-30 minutes later by a big drop you can infer a big hit of insulin. On the other hand, if your BG plot for a full day shows a relatively straight line or only very small ‘waves’ up/down, then you can infer a normal insulin response. A CGM (continuous glucose monitor) is the most useful device you can buy. See my continuous glucose monitor experiment here:

Measure your macros in grams - as you seem already to do - and don’t bother about percentages. Percentages are not useful. At 5’7" and 128 lbs, you’re probably at your normal overall weight and fat comp. I gather from this “microfollicular ovary” that you’re female. Would have been helpful to state this fact right up front. Yes, it makes a big difference!

Just curious. What kind of job requires 14-16 hour days? Daily 7 days per week? Or alternate days? Or days on/off? Also, what’s your age? If you’re getting sufficient sleep then it’s very difficult to calculate time for eating and anything else.

(Bob M) #8

I don’t think this tells you much. If you have a normal insulin and glucagon response, and you’re eating low carb, you’re not going to get ANY rise. Case in point. Wednesday, I ate normally. Thursday I fasted. Friday, I exercised in the morning, and then ate normally.

The rise on early morning Friday? Caused by exercise. Not by eating. What happened to insulin during that time? I have no idea.

Another example:


Here are my notes for this meal:

Basically, zero blood sugar rise (any rise probably due to the small amount of carbs), but I think there was a massive insulin rise. You just don’t see it.

If you’re eating low carb/keto, you probably aren’t getting a blood sugar swing, but you ARE getting insulin hits. I personally eat 130+ grams of protein per meal. I’m sure that causes an insulin hit, but I get nothing on my blood sugar monitor.

(Michael - When reality fails to meet expectations, the problem is not reality.) #9

Agreed. It will be nice when we can measure insulin directly at home rather than attempt to infer from other stuff.

(Bob M) #10

I would LOVE to have an insulin meter. Even a pin-prick one. (I have zero hope for a continuous version.)

There are so many tests I can think of:

  • What really does happen if I eat 160+ grams of protein in a meal?
  • Could I eat different protein and lower the insulin rise (eg, egg white versus whey)?
  • Does eating late really mean a higher morning insulin level?
  • If so, how far “back” do you need to move dinner and what does this mean for insulin?
  • Does my body get something like the glucose intolerance we show when eat lower carb for a long time, where blood glucose spikes really high in response to carbs? Maybe the same happens with insulin?
  • Would the AUC (area under the curve) be better with (dare I say it?) three meals a day instead of two?
  • Conversely, would it be better to eat during a 6 hour window instead of an 8 or 10 hour window?
  • Do different people have different insulin responses to the same food, as they do glucose responses?

I think know the answer to some of these, but I’d like to have some hard data.

(Joey) #11

@annef Well then, for these conditions, a very low-carb way of eating should serve you well. And you have a very demanding work schedule so taking good care of yourself is especially important.

For whatever it’s worth, despite the fact that it’s your only readily accessible measure, that darned weight scale is more of a curse than a blessing.

Of all the things that matter in your life, I’m inclined to believe that how much the Earth’s gravity is tugging on your body mass (i.e., your “weight”) is likely the LEAST relevant to your well-being and long term enjoyment from life.

Perhaps you ought to reconsider whether watching your weight is distracting you from other more important habits :wink:

Best wishes :vulcan_salute:


Thank you Michael for your accurate reply! Monitoring glucose levels during the day sounds like a good habit, I will surely think about it. I am female yes, and the job is financial analyst. I am 24 years old. Sleep is a luxury in my life :joy: but I still make time to plan meals!


Thank you for sharing you results! and as @amwassil also pointed out it would be a blessing to have a way to measure insulin! Unfortunately for now we’re stuck with just glucose and ketones


Love the questions, very interesting, I would really enjoy having those answers as well


Thank you Joey! the scale is deceiving I agree!


For example today my glucose levels this morning got to 4.5 mmol/L (83 mg/dL) in a fasting state, which is higher than my usual average and ketones were at 1.3 mool/L. Ironic since yesterday I ate fewer than 21gr total carbs and 18gr were fibre and I didn’t change anything in my diet.

(Michael - When reality fails to meet expectations, the problem is not reality.) #17