Not understanding my very low ketone ratings

(Dave) #1

Heya, I’m really hoping someone might be able to help with my ketone blood ratings which I’m quite concerned about. To start off I’ve been eating keto for over 12 months and know the diet well. It was never for weight loss but for all the benefits that come from the nutritional ketosis range (generally 1.5-3 reading). I’ve used ketostix before and they have always come back as a dark reading. I know how inaccurate they can be though and have not used one for maybe 3 months now.

I finally bought a Freestyle blood ketone monitor and was mortified to see how low they were. Here in Australia the strips are very cheap compared to USA so the cost is nothing for me to worry about.

This week I’ve been paying extra attention to diet and have been averaging at 120g protein / 220g fat / 30g carbs per day. I remember I was having around 40g carbs per day when getting dark ketostix ratings. One month ago I started intermittent fasting and now only eat 3 meals between 1pm-9pm if this might have any affect?

Here is a run down of my most recent results:

7am - Wake up - Ketone 0.1
1pm - After 16 hour fast - Glucose 76 Ketone 0.6
3pm - 2 hours after 1st meal - Glucose 76 Ketone 0.3
5pm - 20 minutes post heavy weights - Glucose 70 Ketone 0.3
10pm - 1 hour after last meal - Glucose 88 Ketone 0.5

1pm - After 16 hour fast - Glucose 76 Ketone 0.4 (just tested now)

Does anyone know why my readings could be so low? From yesterday, I can’t understand how it could be 0.1 lower after not eating for 16 hours.

Any help would be amazing! :slight_smile:

Low Blood Ketones despite strict keto
  1. Ketone levels in the morning tend to be lower due to cortisol/dawn phenomenon.
  2. Ketone levels after eating or exercising tend to be lower.
  3. Assuming you’re fat-adapted after having been keto for 12 months, the consensus and science is that your ketone levels are lower because (a) your body is more efficient at making them (i.e., not too many or more than necessary); and (b) your body is more efficient at using them, so there’s less free ketones in your blood.

Translation: as long as you’re keeping your carbs low enough (into ketogenic levels), I wouldn’t worry about it and would KCKO.

Here’s a thread that you may find helpful. Specifically, see @richard’s experiences with his ranges.

(Dave) #3

Thanks so much and this was helpful. Knowing my ratios and that I am also quite athletic, I would be fat adapted and that would explain a lot.

If we take a look at graphs for example on which suggests

Weight Loss - above 0.5
Improved Athletic Performance - above 0.5
Improved Mental Performance - 1.5.-5
Therapeutic - 3-6

So does becoming fat adapted and now having lower ketones essentially mean we are no longer able to gain these benefits from having a higher reading? (eg mental performance, if we are to believe its in the 1.5-3 range)

(Sjur Gjøstein Karevoll) #4

You don’t get the benefits of ketones from how much is in your blood, but from how much you’re using. Those levels you cited are also not particularly scientific, they’re more just ballpark numbers. If you want to improve some specific aspect of your life then measure that aspect. If it’s mental performance then find a way to measure that. Don’t worry about ketone levels just because someone said there’s a correlation.

The ketogenic diets that have become popular and that almost all of us follow also aren’t guaranteed to get everyone into ketosis, certainly not all the time. Diets that guarantee you get into deep ketosis all the time are incredibly restrictive and therefore hard to follow and with great potential for deficiency. They are only advisable for people who have some life-affecting condition that requires them to be in deep ketosis all the time, like epilepsy.


its extremely disingenuous to suggest they are “only advisable for life affecting conditions”. many people choose to be in deep ketosis for health and lifestyle reasons. there are no demonstrated downsides as long as its a well formulated ketogenic diet.

(Sjur Gjøstein Karevoll) #6

The well formulated ketogenic diets, modified ketogenic diet, modified Atkins, whatever you want to call them, don’t guarantee you stay in deep ketosis to the degree that a classic ketogenic diet does, and the classic ketogenic diets have been scientifically proven to have some downsides.

Look at for example the 4:1 diet, which is 4g fast for every 1g carbs and protein combined. At a daily intake of 2000kcal this would mean 200g fat and only 50g carbs and protein combined, which even if you eat zero carbs would be on the extreme low end of protein for a sustainable diet. This extreme macronutrient ratio also makes the diet very restrictive and unpalatable.

This isn’t saying you can’t eat a well formulated ketogenic diet and stay in ketosis all the time, just that it’s a little less reliable, and you’re not going to be quite as deep as the extreme diet. For most people they’re not going to have any benefit from those extra ketones anyway.

(Dave) #7

If anyone is interested I decided to do a 3 day fast just to see how high my ketones would go… turns out not high at all haha

24 Hrs - Glucose 3.9 Ketones 0.9
48 Hrs - Glucose 3.9 Ketones 1.6
72 Hrs - Glucose 3.5 Ketones 2.3

(Justin Durgin) #8

Hello. I’ve recently been dealing with something similar. My blood Ketone meter has been giving me readings as low as .2 mmol/L. The highest I’ve been able to get in the last week is .4. I’ve been ketogenic for 5 months, with only one or two days with carbs over a hundred grams. For the most part less than 30, and those mostly incidental from nuts and eggs. I work out every morning from 4 a.m. to 6 a.m., running and lifting, so I am thinking that my increased activity and exercise make my body extremely efficient at using the ketones? I’m not really sure. I wanted to test it, so I purchased some exogenous ketones. I have tried taking them pre work out in the morning, and tested my ketones after a workout. I have attempted post-workout, at midday, before/after dinner, and test an hour and two hours later, just to see if I can flood my body with ketones and get a really high reading. No dice. The highest I’ve gotten is .4. the only thing I can think of is that my body uses ketones extremely well, and when they are available I do not waste them. There is nothing in my diet that would cause me to fall out of ketosis. And aside from Bulletproof Coffee at 3:30 in the morning, I typically only eat once a day at around 6 p.m. So I fast generally 22 or so hours a day I’ve been trying to find some information on the forums about this, but I have yet to find and extremely well-trained person comment on having very low Ketone levels, aside from what I’ve read on this post of course.


more info than you probably want but it has value if you can get through it

(keep in mind they are “selling” the idea that you can super micro manage nutrients to make it “optimal”)