I have been eating keto lifestyle now for over 2 years but has only been the last year Ive started using a blood meter to monitor after having weight gain and water retention yo yo regardless that I keep my eating clean. What I am confused about it not seeming to get high numbers or even hold ketosis during certain times of month (during my period numbers are nil). Im 43 hours into a fast and still only showing as .4 usually after 120hours I can get to as high as 4.0 but as soon as I eat the number plumet until Im out again. I eat well under 20 total carbs, zero processed foods/sauces, no sweetners or extras. I eat meat, eggs and fat omad. I can fast for days so sure there is some fat adaption but yet no weight loss. What am I doing wrong? I honestly dont understand these keto numbers other than Im supposed to aim for 1.5 which for me seems impossible to hold.
Newbie Question for experienced keto eater
If you really are eating sub-20 grams of carbs per day and still breathing and conscious, you’re in ketosis. The numbers don’t mean a lot unless you’ve got a medical condition that requires specific concentrations of ketones. Otherwise, you’re OK.
Being in ketosis for a long time, your ketones will have leveled out, unless you still have a ton of weight to lose.
If the number is 0.0 or trace, that’s false - it just means that your prime fuel source is still fat, without you being in ketosis. This happens sometimes.
Your metabolism can burn fat whether or not you’re in ketosis. People on high carb, low fat CICO diets can lose lots of fat over long enough time. It’s not efficient and requires severe calorie restriction. Fat is not the prime fuel source. This is the only condition in which you can be burning some fat and not be in ketosis.
When you’re eating sufficiently low (generally sub-20 grams) or no carbs, you will be in metabolic ketosis or dead very soon. There are many reasons you can show zero ketones on various devices yet still be in ketosis. No device thus far invented measures ketones produced/used, only those not in use or discarded.
So, you just said that you can be burning a bunch of fat without ketosis, and then said you can’t be… Excuse me Mike?
Dr. Phinney says .4 or higher to be in nutritional ketosis. Remember, what you measure is only going to show what you did not use for fuel. You are probably just using those ketones to function.
Stressing out about a number won’t help anything.
Keep Calm, Keto On.
Dr. Stephen Phinney and Prof. Jeff Volek, the researchers who coined the term “nutritional ketosis,” define it as a serum β-hydroxybutyrate of 0.5 mmol/L or higher. They admit that this is pretty arbitrary; it’s just the point at which they generally see the benefits of nutritional ketosis in their research subjects. Dr. Phinney has stated in numerous lectures that, while 1.0 may be a bit better than 0.5, there is really no apparent benefit to higher levels of β-hydroxybutyrate than that in the blood. It also should be noted that the elite fat-adapted athletes Phinney and Volek have studied tended to have a level of β-hydroxybutyrate under 0.5.
So it is clear that it is possible to experience the benefits of a well-formulated ketogenic diet in a wide range of β-hydroxybutyrate levels.
@ellenor2000 You are confusing ketosis and fat burning (lipolysis). See the link I provided above.
I said one can burn fat without being in ketosis. CICO diets demonstrate that. I also said if one is not eating sufficient carbs to sustain life, and sub-20 grams per day is insufficient, you will either be in ketosis or soon dead from starvation.
I am definatly not dead and eat carnivour so am basically at zero carb (aside the few in eggs or liver). The medical doctor who originally got me into this way of eating had me testing ketones pre-meal and post-meal 2 to 3 hours after to “discover” what works for me as I seem to have lots of sensitivities according to him (5 day fast and low keytones until I cut coffee out then they jumped up for example) however I dont understand the ups and downs and it frustrates me likely creating more issue in already stressful times 
The things that influence ketosis are primarily glucose, insulin, glaucagon and lipolysis. The amount of ketones actually produced varies considerably, likely due not only to all the factors we know about, but probably also to other factors we don’t and their various interactions. Many of us on the forum have tracked ketones by various methods mostly to discover that, although interesting, it’s not very useful. Not only that, but none of the currently available devices actually measures ketone production and utilization - only what’s not being used (blood meters) or what’s being discarded (breath and urine meters). Unless you’ve got some metabolic disorder that requires a specific concentration of β-hydroxybutyrate, I wouldn’t worry about. You can fix that with exogenouse ketone esters if that’s the issue. Keto is a metabolic normalization process and that can take time depending on what and how much needs to be fixed.