Never checked for ketosis

(Robin) #1

Am I alone in going full keto without ever checking to see if I am “in ketosis”? It’s working, so I’m assuming it ain’t broken…?

(Bob M) #2

I didn’t start checking until I had been low carb/keto for over 1.5 years. Back then, the blood strips were $5/each, so I didn’t test that often.

If you’re eating low carbs, you’ll be in ketosis.

(You've tried everything else; why not try bacon?) #3

I’ve never measured ketones.

(Michael - When reality fails to meet expectations, the problem is not reality.) #4

As someone here once (maybe a few times) said, if you’re eating sub-20 grams of carbs per day and are still breathing you are in ketosis.

#5

I think you’re right! I like testing things, but there’s so much that doesn’t make sense, anyway! Why bother!

(Bob M) #6

Dude! How will you know whether increasing protein causes your ketones to drop? :wink:

(Let’s ignore that if you’re increasing protein, you’re decreasing fat, so maybe – if your ketones do go down – it’s the decrease in fat and not the increase in protein.)

#7

Exactly, unless there’s a real reason for it constantly checking that is a complete waste of time money. I don’t even want to think about the money I’ve lost with that stuff.

(Robin) #8

I too like money!

(Stephanie ) #9

Been keto since March 2018, never checked, not even once. Lost 85 lbs :blush:

(Amy) #10

I agree that you don’t need to check, but I like to. I feel like I’m my own science experiment and checking, at least at first here, helps me define the boundaries. Positive reinforcement, if you will. It’s a personal thing. Also, I share the meter and cost with my keto buddy.

#11

Im doing dirty, lazy keto- loosely less than 50gm carbs per day. Dropped 20lbs in 2.5 months which I’m happy with and don’t ever plan to check ketones.

Also, some intermittent fasting in there but not planned just happens.

#12

That’s my goal as well! Good for you!

#13

I reckon you would be in the majority Robin. But I have no data, it is a presumption I hold as a belief. More accurately you are going low carbohydrate in a dietary approach, which can be ketogenic. “Full keto” suggests a position of knowledge. Or, “full keto”, is a metaphor.

This could be viewed as a discussion about knowledge and presumption. Not measuring breathed, blood, or urine ketones and eating a low carbohydrate diet is based on a presumption of “full keto”. Whereas, measuring breathed, blood and/or urine ketones is factual knowledge.

Facts are the building blocks of useful knowledge. Fiction, could be also labelled ‘stories’ provide a different basis of knowledge, a system based upon belief. Belief based systems can be very powerful and convincing.

This is not a story of right or wrong. It is, hopefully, about facts and nuance.

People who are mentioning that they are losing weight (a measure), or changing clothes sizes (a measure), or able to be more active (e.g. able to climb stairs - an observation, but if they count the steps it’s a measure). Some people may be testing fasting blood glucose and extrapolating from there (the test strips are cheaper). All these could be considered proxy-markers of the benefits and effects of a low carb dietary approach that can result in nutritional ketosis. So, in an indirect way ketosis may be measured. It is not accurate.

It may not need to be accurate for one’s goals.

This morning fasting blood glucose: 5.7mmol/L (102) - a bit higher than what I would like. Fasting blood ketones 0.2mmol/L - a bit lower than I would like. I am in ketosis, but I am not in nutritional ketosis. The fact that I have some blood ketones tells me that I am in a low insulin state. But my blood glucose is a bit high, could that be sympathetic nervous system activation, a stress response? If I saw this reading without checking for ketones, I would presume that I was not in ketosis. I would be inaccurate in that presumption but still hold it as a belief.

Straight away I can see that I could improve what I am doing. Or, straight away I can start asking myself questions. How did I sleep? - I went to bed late (11.30pm) and slept until 7.45am (more measurements). That’s a bit over 8hrs sleep. What did I eat last night? etc

OK, so I’m on a carnivore challenge. By measuring I know, rather than believe, that eating a very low carb way does increase my fasting blood glucose. This can be due to a normal physiological insulin resistance (of the muscle). Or, it may indicate that my autonomic nervous system is activated down the sympathetic pathway (flight, fight, fright or freeze) stress response. Then I can interrogate stress.

From knowing n=1, I can build from a depth of population knowledge about what is believed to happen to most people when they eat less than 20g of carbohydrates a day, to what actually happens to me.

OK, that’s my case. I have been in ketosis (>0.1mmol/L) and nutritional ketosis (>0.5mmol/L) for a majority of the past 6 years. That is confirmed by blood ketone measurements. Often when eating very low carb carnivore my blood ketones are 0mmol/L. So, despite ‘zero carb’, I am not in ketosis. I note this to highlight that carbohydrate restriction is not the same as nutritional ketosis.

Where it becomes important for me is when things are not going right.

Not checking for ketones while expectations of eating low carb are met is a pragmatic approach. It ain’t broken KCKO.

Sometimes, one can believe that they are eating low carb and achieving nutritional ketosis but be completely baffled by weight gain, or a stall, or hunger, or cravings etc. That is the time where measuring ketones, and having measured ketones is very helpful in troubleshooting.

What’s become apparent in my rambling, though, is that measuring ketones is not the ‘be all and end all’ measurement. Possibly being able to measure insulin will be? What is apparent is that there are a plethora of proxy-biomarkers and observations that are also valid to a degree to understand one’s own health trajectory.

TLDR KCKO

(Bob M) #14

As an engineer (aka “enginerd”), I love to test things. I have thousands of tests, a combination of every type of ketone (blood, breath, urine) test and many different blood sugar tests (have at least 5 different blood sugar meters, including Swedish and US CGMs).

What I do now is not test anything, except breath ketones, and that only because I have the ketone tester (ketonix) on my desk at work.

One reason for that is I found it really difficult to test anything to any degree. The devices we use have high error, and when I would test things, I would be convinced something was true…only to find a time when it wasn’t. And then again when it wasn’t.

For instance, does eating later cause higher morning blood sugar? Maybe, sometimes. Other times, maybe not.

So, after a while, I gave up. I just assume that if I’m eating low carbs and my belt holes and pants seem to be going in the right direction, I’m OK.

Now, I would continue to use a CGM if I could, but they’ve gotten very expensive. And I’d love to have an insulin meter. But that’s a story for another day…

(You've tried everything else; why not try bacon?) #15

It can be a vexed question. There are both personality issues (I could never have done keto if I thought that counting calories and measuring glucose and ketones was a requirement, whereas other people feel much more in control if they are measuring), and there are issues of understanding what the data mean.

For example, I have been pondering the matter of measuring food intake in terms of its caloric content. We do that because, 150 years ago, the only information we could find out about food was how much energy it yielded when we burnt it. But how relevant is that to how the body uses food? We include protein calories in our count of “energy in,” when we know full well that only a very small amount of protein gets consumed by gluconeogenesis and that amino acids aren’t otherwise metabolised unless the body is in dire straits. We also know, nowadays, that the metabolic cycles that utilise glucose and fatty acids do a lot more to turn food into useable energy than simply oxidising it. We would probably do better to estimate our food intake by how much ATP can be made from it or something, rather than counting calories. But people keep counting calories anyway. Why is that?

Likewise, do we really understand what ketone levels mean? I suppose we can assume that if our body is excreting ketone bodies, we must have enough in circulation to be able to afford to waste some. But what do we really know about serum ketones? And why don’t we measure serum acetone and acetoacetate? Why only β-hydroxybutyrate? Shouldn’t we know the levels of all three? Are we really certain that if we measure x β-hydroxybutyrate, we can be confident that there is y acetoacetate and z acetone in our blood? All three of them feed the brain, after all, and all three have been shown to have epigenetic effects, so why do we care only about the level of one of them? And if the elite athletes Phinney and Volek studied can be in ketosis at 0.2, do we really need to worry if we are at 0.5 instead of 1.2?

To quote Rodgers and Hammerstein: " 'Tis a puzzlement."

(Michael - When reality fails to meet expectations, the problem is not reality.) #16

We love a simple solution to a complex issue because it requires less effort to understand than the more accurate but much more complicated explanation, even when it’s obvious the simple answer is inadequate or wrong. Even though CICO ultimately fails 99+% of the time, it remains the preferred solution simply because it’s easier than figuring out how much of various nutrients contribute to one’s daily energy balance and overall metabolic health. Not even to mention trying to figure out what’s actually going on with ketones.

(Scott) #17

Never tested once and lived to tell the tale.

(Kirk Wolak) #18

You are probably not alone. As you can see here…

But it makes me very jealous. I had to. I had a 5g/day strict limit on carbs.
Eventually I ended up carnivore because of inflammation and migraines from vegetables.

I can’t imagine making it work without testing. Even now, if I eat something I shouldn’t, I can swing 7-8 lbs overnight, while BEING in ketosis. So testing is NOT the be-all and end-all…

Then there is my wife. Who eats an American/Mediterranean diet. Way too much bread, carbs everywhere. Drinks her own Homemade Sugared drinks. And walks up to me, and has me test her. Turns out, she was IN KETOSIS. She is NEVER hungry, and will skip eating if the meal is NOT 100% what she desires to eat. I NEVER understood how she could do that. Now I know. She has been naturally in ketosis her whole life.

And while she eats whatever she wants… I’ve rarely seen her eat more than 1/4-1/3 of a Ben & Jerry in one sitting. She has a very intuitive way about what she eats. She enjoys 1/4 of a chocolate bar, and the rest will sit in the fridge or the cupboard for WEEKS before she even thinks about it again.

I am totally jealous, because I used to go through that cupboard and finish everything she had left opened. LOL. Oh, she hated that. She would not notice until she WANTED something… And then be so angry at me. [It’s made my journey especially hard, because she refuses to NOT have that stuff in the house. I left the house for 7 months to kickstart myself to avoid all the temptation!]

So, count your lucky stars, you never had to. And there are people everywhere on the spectrum. I am certain if we tested most naturally skinny people, we will find they are fat burning for a good part of the day!

(Robin) #19

My husband finally joined me on keto, for heart issues. But he’s been naturally thin all his life, eating CRAP! I used to finish every bag of his chips when it got low_ish. No willpower. I would look at labels that say 4 “servings“, and think four “minutes”. All mine. In one sitting. I agree that some people are naturally inclined (probably genetically) to be either in ketosis or to burn their calories efficiently. BUT… that does not explain their ability to walk away from Ben and Jerry, does it??? I think it comes down to personality types. My daughter would save her Halloween candy for months and had to hide it from her brother, who would have eaten all his on the walk home. She is naturally restrained and moderate in ALL things. He and I are both always chomping at the bit for more of everything… life, thrills, food, whatever. Just different personality types? Me thinks so.

#20

I have been cycling in and out of nutritional ketosis for about 10 years now. First, to lose weight (20lbs) secondly, as a performance enhancement to my sport. In the first 3 months, I lost 20.3lbs of fat (confirmed by DEXA Scan). I also did blood tests before and after the 3 month time period. My blood markers for inflammation decreased dramatically over these 3 months. My cholesterol markers also improved. I started with a baseline so that I could compare my results over time. What improved and what got worse. Not all eating plans, including Keto, are healthy for everyone. For example, my good friend ( a Dr) tried Keto and his triglyceride numbers went through the roof. Unless you measure, how do you know with certainty that Keto is working AND is beneficial? My experiences are that most people who measure their Ketone levels, gain a greater understanding of what works and what doesn’t work for them. You should never be hungry on the Keto program. If you are, then maybe you should test and see if something is out of whack. This would include, your macros and overall caloric intake. A lot of people on Keto lose weight initially because they reduce their caloric intake. Fat satiates, and therefore you are not hungry and by extension, you eat less and create a caloric deficit. Short term this works, however, in the long term it does not work if the goal is weight loss. I have a blood test approximately every 6 months now and will test blood ketones only after a 2-3 day fast. On high exercise day (6-8 hours) my carb intake could reach 150grams+ with no adverse effects.
I am not a medical doctor and do not claim to know all things, Keto. However, I strongly suggest at the very least to go get a complete blood test before beginning and then at the 6 month time period to see what is working and not working while on the Keto journey.