Still don't understand what ketosis is

#1

Hi all. I had given up on keto over the past few months, because I felt like it was no longer giving me the benefits I initially felt. The 10-ish pounds of weight I wanted to lose were back; joint pain was still bad, energy was not great.

I’ve been using the past few months to better track my baseline symptoms and the foods I eat (when I don’t make an effort), because I do want to give keto another shot, but I don’t want to make the effort unless I am sure I feel better. My main issue is inflammatory pain that is probably rooted in a poorly understood autoimmune condition.

For background, I have never eaten SAD, and I don’t believe I have any metabolic or insulin disorders or weight problem. My dietary history has been to eat a lot of fruits and vegetables and some whole grains, although my current, non-keto “baseline” consists of less of those than before – I guess out of new habits from two years on keto.

Here’s my question. I’ve been measuring my blood glucose and ketones since January 1, using the keto-mojo. My blood ketone level is never less than 0.3 even after eating an occasional dessert. Am I in ketosis?

Related question: if I am registering ketones, shouldn’t I be fat-adapted? But I can’t fast or even do OMAD, so I wonder.

I’ve also measured blood ketones in my sister and husband (who naturally don’t eat sugary, processed foods but also don’t try to limit carbs), and they also register around 0.3. Are they in “ketosis”? I feel like I don’t understand what is going on in my body, or what I should aim for (in terms of reaping benefits of “ketosis”) to feel better.

I thought ketosis was an on/off switch, but how can that be, given my experience and the measurements I’ve made on others who don’t limit carbs on a regular basis?

(Robin) #2

There are folks who track their ketones and those who don’t. From what I have read here in the forum, it is not always a steady and straight line.
I never measured, because I knew I was already following keto protocol… and I saw the results. Which are also individual… fast, slow, up, down.

Without more info on what days worth of food is for you, it’s hard to give more input.

#3

Thanks. I’m not exactly asking for input on my own diet, since I have not yet started back on the keto WOE. I’m more scientifically curious about what exactly constitutes being in ketosis metabolically, since it appears people can be in it without following the keto WOE. Well, that is what I’m assuming, if 0.3 blood ketones (measured from keto-mojo) can be called ketosis. Maybe it is not?

(Robin) #4

Thanks for the clarification…. I’m sure you’ll get some good feedback.

#5

Were you tracking what you ate? If you weren’t losing, and regaining, your diet wasn’t right.

People always wind up going in and out of ketosis, whether they eat keto or not. If you weren’t using exogenous ketones, and still registering them, yes, at the time of testing you were in ketosis.

Being in ketosis and being fat adapted are two different things.

It’s not, it’s a spectrum. We also burn both fat and carbs, as do people not eating keto. It’s not a 100% one way or the other. Think of all the people eating low fat super high carb losing massive amounts of bodyfat. None of this is set in stone, it’s all up to the context of how you’re doing it, and of course activity levels.

(Joey) #6

@Wendy198

Check out this link. It might help you better understand what ketosis is in scientific terms:

#7

It says:
Trace levels of ketones are always present in the blood and increase when blood glucose reserves are low.
And it also says baseline is 0.3 so maybe I have not in fact been in nutritional ketosis, which makes sense since I’m currently not trying to be.

#8

I leave the ketosis things for others, I don’t even ever measured anything.

Being fat-adapted may have some correlation with fasting abilities but…

  1. there are other factors
  2. it’s not true for everyone.

As I lowered my carb intake, fasting got harder and harder though it’s not so simple, other factors, different days and fat adaptation do help something - but I often get satiated too easily on very low-carb so I need to eat in a bigger window to get enough.

As far as I know many ketoers never fast as it’s just not something they like. Just like I did IF on all woe as that came naturally, I just don’t get hungry in the morning (very rarely before 2pm), my diet doesn’t matter.

So you easily can be fat adapted and not being able to do fast but if you abandoned keto for month and ate way more carbs, you probably lost it…? I don’t know how these things go, maybe no one does… I know it’s very hard for me to lose it but I don’t stray far or just for a day and go back to very low-carb often. When I still could have some longer, carbier off times, my fat adaptation benefits started to go away but just some slightly off time couldn’t do the trick. I have read little about these things but it seems others are similar, fat adaptation doesn’t go away just because you quit keto but eating much carbs again eventually ends up with that.

And ketones should say something about ketosis, not fat-adaptation. I don’t even know if you can figure out if you have it - apart from some serious signs if you personally have those. I felt about no change when I went keto but it was very apparent after 7 weeks so I use those things to decide if I have fat adaptation, it’s not a sure thing but should do. I can’t tell if I am in ketosis so I use my estimated carb intake to have an educated guess… But I actually care for feeling right so I just listen to my body and do what I know working for me. (But I doubt I am not in ketosis when I do so. I got fat adapted smoothly with way more carbs.)

(Joey) #9

There’s also the measurement error dimension. If you test keto blood levels with a consumer quality meter (e.g., KetoMojo, which is a good one) multiple times in a row, you can get a range of answers that fall within the meter’s stated measurement tolerance (see accuracy and standard distribution info on the meter).

Moreover, given a fairly low number, there’s also the possibility of additional measurement error because the trace amounts of the BHB ketones present are more difficult for the reagent strips to accurately/precisely detect at low levels.

#10

I have done a few tests of ketones in a row, and keto-mojo seems more consistent with ketones than blood glucose. The ketone measurements have always been within 0.1 mmol/L of each other, whereas blood glucose measurements vary wildly, sometimes as much as 20 mg/dL. But thanks for the feedback. I think 0.3 is not deep enough into ketosis to expect anything amazing to happen. When I restart, I will aim for more like 0.8+ and see how that feels.

(Joey) #11

I’ve also found my glucose results fall within a wide band (not just on the Mojo). My BHB levels rose sharply (to 5-7) shortly after cutting out the carbs. Then slowly over weeks/months they settled into 0.5 to 1.0 on the Mojo. Then, after about 10 months or so, I got tired of sticking myself with a pin (at about $1 a pop) and stopped testing ketones.

From time to time I get interested in glucose response to certain foods or exercise, so I got a cheap Walmart glucose monitor for “entertainment” purposes. At some point, you learn enough about your body to get on with the joy of living in it. :vulcan_salute:

#12

That’s what I am searching for! Hope to find answers at some point.

(Joey) #13

One further thought: If you’re not already doing so, be extra diligent in washing your hands before handling the ketone and glucose strips. There are reports of wildly inaccurate readings from contamination on the fingers.

(Bacon is a many-splendoured thing) #14

In that case, a low-glucose (carbohydrate) diet is probably just what the doctor ordered. Lowering glucose low enough also lowers insulin, which helps with the systemic inflammation. Avoiding industrial seed oils (soybean, cottonseed, flaxseed, sunflower, corn, canola, etc.) should also help, since they contain inflammatory polyunsaturated fatty acids. Stick to the traditional cooking fats (butter, lard, tallow, bacon grease), which are very low in polyunsaturates.

(Bacon is a many-splendoured thing) #15

The definition of nutritional ketosis used by Phinney and Volek is 0.5 mmol/mL of serum β-hydroxybutyrate, which even they admit is somewhat arbitrary. But in general, any diet low-enough in carbohydrate to lower insulin below the threshold amount will allow for ketogenesis in the liver. How strictly carbohydrate will need to be limited will depend on one’s degree of insulin resistance.

Ketosis and fat-adaptation are different phenomena. Ketone bodies are produced in the liver when insulin drops low enough (which requires a sufficiently low carb intake), but fat-adaptation happens at the cellular level in skeletal muscles, which have deactivated much of their fatty-acid-metabolising pathways from disuse. The reactivation and the healing of the mitochondria from glucose overload take generally something like six to eight weeks in most people, but we enter ketosis as soon as enough glucose has been cleared from our blood stream to allow insulin to drop sufficiently.

#16

Got it. I think I might need to reactivate my skeletal muscle fatty acid metabolizing pathways. I might have been getting there during my first 8 months on the keto WOE, but I somehow got derailed in my second year, even though I was consistently producing ketones at some level.

(Bacon is a many-splendoured thing) #17

Fat-adapted muscle will pass up both glucose and ketone bodies in favour of fatty-acids, sparing the two former for those tissues that can really benefit from them. At that point, most people tend to find their measured serum β-hydroxybutyrate dropping, as the liver more precisely matches production to consumption. At this point, such people tend to panic, thinking they must be doing something wrong.

But as one forum member posted (and I couldn’t help stealing the joke), you can use the following two criteria to tell if you are in ketosis:

  1. You are eating less than 20 g/day of carbohydrate; and

  2. You are still breathing in and out.

#18

I’ve got my ketones up to 0.8 and still haven’t lost a pound. Might have even gained one. Glucose in the 90s at most random test points but sometimes 80s. So frustrating!
What I ate today;
Two coffees with heavy cream and collagen
3 eggs with butter, sausage and a few green beans.
About 1 ounce of manchego cheese
And just now - because it seems so hopeless - a slice of fresh pineapple…
My calorie intake is usually close to 2000 so I’m guessing I am simply consuming too many calories for my activity level.

(Bacon is a many-splendoured thing) #19

I don’t see how three eggs, a few green beans, an ounce of cheese, and some collagen adds up to 2000 calories.

You might like to try eating to satiety, since even on a low-carb diet, the body will resist parting with its fat store in the absence of an adequate caloric intake. Eating at a caloric deficit is futile anyway, since studies have shown that the constant hunger from eating less and moving more inevitably results in eating at some point. And when that happens, people tend to regain not only the weight they lost, but an additional ten or twenty pounds (5-10 kg).

Another possibility is that you are significantly insulin-resistant, to the point where you will need to cut your carb intake even lower, in order to get your insulin low enough to put you in fat-burning mode.

#20

Thanks @PaulL
I understand the problem with calorie restriction, which is why I’m not trying to restrict. My calories as of today (before dinner) are 1135, according to Cronometer. (The sausage portion was large and not your basic breakfast sausage!) I’m not hungry right now – and would love to be able to skip dinner, but I doubt I will be successful. I am hoping to eventually be able to fast, or do OMAD, because I think fasting would help me on many levels. I guess I will just keep trying…
P.S. The heavy cream adds up!