SGLT2 inhibitors ( Invokana) and ketosis


(David ) #1

Reading more extensively about SGLT2 inhibitors ( Invokana) and it seems that one of the properties is that it causes a decrease in the renal clearance of ketone bodies and could also increase the plasma ketone body levels. I know our body gets used to using Ketones and I saw the decrease in urine strips at about 3 months, wondering if the reason I see zero now is that of the SGLT2 Inhibitors?

I am doing well and am fully keto-adapted after 7 months, but am looking to talk with my doctor about taking me off Invokana ( A1c 4.8)


(Bacon is a many-splendoured thing) #2

If the drug is preventing the kidneys from clearing acetoacetate from your bloodstream, then yes, your urinary ketone level should decrease as a consequence.

Note, however, that urine testing becomes ineffective in any case, from what I read on these forums, since the body uses ketone bodies more effectively once it becomes fat adapted. It is possible to have a decent level of serum beta-hydroxybutyrate, even with no acetoacetate showing in the urine.


(David ) #3

Thank you Paul, when I FF or IF the levels show in urine strips. I am getting a blood meter so I can actually see, but I agree- I probably am around the 1.7 level. Hit the 100 # loss yesterday.


(Bacon is a many-splendoured thing) #4

Whatever you’re doing, it’s working, so keto on! :bacon:


(Bacon is a many-splendoured thing) #5

Just watched Mike Mutzel’s interview of Sarah Hallberg, which @atomicspacebunny posted here:

Around 37:30, Dr. Hallberg states that someone taking an SGLT2 inhibitor on a high-carb, low-fat diet is at risk for ketoacidosis, whereas on keto/LCHF, the risk is practically non-existent.