Ketones readings

(Vivienne Clampitt) #25

So reading the article I need to keep my GKI at between 1 and 3 in order to improve the type 2 diabetes and/or lose weight ( only have 7- 11 pounds to lose!).
Currently BS running at 8.0 mmols/L so I would need to have ketones running at between 2.666 and 8.0 at this moment in time! I can get a rough idea of BS levels at any time with a freestyle libre, but can be costly checking ketone levels (strips needed at an extortionate cost per strip!)
How often do you check ketone levels?

(Beth) #26

I check mine once a day in the morning. I checked them after meals along with BG for about a month to establish a pattern but not now. They’re pretty predictable for me. The only time they drop is after carbs or alcohol, and they’re back up within 24-48 hours of fasting. YMMV.
If the expense is an issue, just track blood glucose. Walmart has BG monitors for $12 to $20 with pretty cheap strips.
Now that I fast more I spend less on food, so I budget some of that to cover the cost of my BG & ketone strips.


The optimal basal level for BG is about 80 mg/dL (or less). So that’s my eventual target. My BG levels out to 55-65 during a block fast. Because of my IR, setting my target to 80 would necessitate more fasting, which would cause unwanted weight loss.“normal”-blood-sugar-isn’t-normal-part-2/

The problem with this protocol is that it causes rapid weight loss. That may not sound like a problem, but both me and @KCKeto have had to “put the brakes on”. I don’t want to be a 120 lbs waif.


Unless I’m experimenting, I only check my BG (and BK) when I wake up. I normally don’t do it before or after meals*. I have not adjusted my target numbers, they are at the ideal. As my insulin sensitivity has improved, I’ve increased my feeding days.

*The true measure of insulin sensitivity is how the body responds to a stimulus. In clinical settings its the OGTT with insulin. Recently, I decided to add this to my program. I will do an at home version (following Chris Kresser’s protocol) to measure my progress. Once a month, I will eat the same meal and measure my BG. Over the ensuing months I hope my response time to basal decreases.

(Beth) #29

This is a very valuable article!
FWIW, my functional medicine doctor adamantly agreed that this approach is much safer and preferable for tracking progress instead of getting an OGTT in a lab, because of the dangerous and uncomfortable blood sugar spikes Kresser mentions in this article. I won’t do another OGTT in a lab without having someone to drive me home and high fat snacks for after. Maybe not even then.
I”m glad I did it, for the diagnostic info, but my reaction bordered on dangerous.


Thanks to you both @KCKeto and @4dml, this is super interesting, I am eager to give it a shot and see how it goes!

(Beth) #31

Let us know how it’s working for you.


Sorry for all the questions, but I have another one (sorry if it was asked before, I didn’t see it).

You both take your BG in the morning to determine if you should eat, right? And you will only eat if it’s <70 (assuming it was >85 earlier, leading you to fast). Do you account for dawn effect at all? I’ve gotten into the habit of taking my BG out of curiosity once a day midday before lunch and at least 5 hrs after morning coffee with HWC). The first time I’ve gotten anything lower than 70 so far was yesterday, at about 40 hrs into a fast (6 hrs post-coffee) when it was 65 mg/dL, which leads me to wonder if it would have been over 70 if I had taken it first thing in the morning due to dawn effect.

I’ll start checking it in the morning, but I’m wondering if you assume your BG is naturally higher in the morning due to dawn effect and use that as your deciding factor anyway, or if you account for it being higher somehow?

I hope that made sense!

(Diane) #33

I’m fascinated by this idea of timing my fasting using this protocol.

Don’t know if this will help, but I joined the IDM program and read through their information/instructions. They suggest not eating until at least 3 hours after waking up (or within the 3 hours before bedtime). So, I’m trying to check my BG just before my first meal of the day (hopefully avoiding any dawn effect with the timing of the measurement).

Anyway, that’s my plan. But I guess that whichever approach you use, the important bit would be consistency. And making slight adjustments if you don’t see progress as you go along.


That’s an excellent point you make about consistency. I have a hard time waiting for my coffee. :smile: I’ll track both mornings and middays for a while and see what patterns I find.

(Beth) #35

Have you seen this? This also has really helped me keep my GKI where I want it. When I eat, I choose low insulinogenic foods from these charts.

(Beth) #36

I used to experience some dawn phenomenon but on this approach it gradually stopped, then reversed, meaning I now have the opposite effect. My morning BG numbers average about 10 points lower than my afternoon and evening BG numbers (pre-meal). YMMV.
I agree that consistency is probably key. The tracking is an autopilot habit now and I love how
such simple data lets me observe trends, tweak things, and see how it’s improving.


I checked at 6 am and it was 69, after having been 88 last night before dinner. I ate anyway, but I’ll try to stick with the morning readings and go by those. This is so fascinating. I had always thought dawn effect was a hard and fast rule. It’s very interesting that yours reversed. I have never been diabetic, but I know I must have had some IR. Those midday BG readings I was taking have come down significantly since starting keto and fasting. Thanks so much for taking the time to answer my questions, I’ll let you know how it goes!


I don’t have the Dawn effect. You may need to adjust your target numbers to factor this in. I set mine taking into consideration:

  1. How much my BG drops during a 12-18 hour period (15-20 mg/dL)
  2. My block fasting BG (55-65)

Thus my upper limit is 20+65=85. So long as what I eat doesn’t raise my BG above 85, I know that I’ll be in my fasting range within a day. Someone who is more insulin sensitive could drop their BG by 50 points. In that case, their target would be 50+65=115. Someone who has a higher fasting BG (for whatever reason including the Dawn effect) would also have a higher target.

Unless you’re trying to lose a lot of weight quickly or are addressing health issues, set a target that allows you to eat on a regular basis (at least every other day). Don’t worry if it’s above the ideal range. As your metabolism heals, you can lower the target over time.

PS: it seems a LC diet may not cure the Dawn effect. I wonder if a block fasting protocol, implemented over the long term, would be curative.


Thank you so much for the detailed explanation!


2 days ago I had low keytone readings, I did not consume enough fat, and was under 1000 calories, yesterday AM blood keytones read at 0.2. I focused on getting the macro combination up.
Yesterdays calories were about 1655
4% carbs (19g; sugar was 7)
25% protein (106g)
71% fat (133g)

I stopped eating at 3:15 PM
Keytone read 2 hours later: 0.9
Keytone reading 3.5 hours later: 1.2

Keytone reading 5 hours: 0.9

I was most interested to see what the reading will be today am - and will see if adjusting (increasing calories to recommend macros) make a positive difference

This am. The reading was 0.9 again.
I continue to drop weight (and bf%)

I’ll be repeating my readings and trying to hit the recommended 2200 (which is 30% deficit)
166g fat - 68%
160g protein - 29%
17g carbs - 3%

The goal is to see if the keytones go higher, or if this is the rangle my body likes to be in.

(Vivienne Clampitt) #41

That is interesting. I have been following Low carb for around 14 weeks or so now, I always get a dawn effect - starts at around 3:30 in the morning and then rises steadily until 10 - 11. Then it will drop slowly throughout the afternoon to the evening. By the evening BS is at an acceptable level ( but not low enough )
I usually only have coffee with double cream in the morning - 2 cups. Sad to say I never measure the amount of cream I put in the cup, probably not a good idea.

I am having trouble getting the numbers down to a better level, so have now started IF, starting a second week today. I know that this will bring my BS levls down by the end of the week - but they seem to creep up again over the weekend.

I am wondering whether block fasting at this time will work for me at current BS levels and BK levels.


If eating ceases, the body will use internal stores to meet its energy needs. Thus, block fasting will undoubtedly decrease BG and increase BK.


To add some insights to my own q; I’ve found that my keytones measure around 1 and like to stay around there.

Yesterday I fasted with 30g fat + 25g protein in my morning coffee and then just 30g far in my afternoon coffee, nothing else and noticed that over the day it rose to 2.1 before going to bed, and it was at 3.3 this AM, BG was down to 68. (That’s a 40 hour window)

This is good enough insight for me and gives me a better idea on how to optimize feeding and keto state.

My timings already result in a 16 hour fast daily, but this added 40 hour fast every now and then seems to be great (as long as I don’t start losing muscle mass).

(Vivienne Clampitt) #44

Thank you for your reply. I have only really started introducing fasting recently , its all a little confusing at times. I really want to properly understand and to find out what works for me. I can manage 16:8, 20:4 and have managed 3 x 36 ( but on these occasions - 3 times in recent weeks - I find I cannot carry out a second week immediately following of any type of fasting. although this week I managed a 42 on Monday but for the rest of the week have got the munchies and as a consequence BS has gone up again!!)
I guess I just have to work out what will work for me!
Thank you for your time .