Very low Glucose and High Ketones at the end of first week?

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(Jake) #1

Hello : I followed a 1500 Calories / day diet (carbs < 20 gms ) and my glucose levels went (too) low and Ketone levels went up rapidly. I also exercised daily (20 mins cardio, followed by 40 mins of strength training) and practiced Intermittent fasting ( one hour feeding / 23 hour fasting). My stats are in the format ( BG Blood Glucose mmol / L, : Glucose mg/dL,) (Ketones (mmol / L ) : (GKI)
Day 1 : BG (4.4 / 79.2) Did not measure Ketones
Day 2: BG (4.7 / 84.60) Did not measure Ketones
Day 3: BG (4.2 / 75.60 ) Ketones (1.60) GKI (2.63)
Day 4 : BG (3.6 / 64.8) Ketones (2.70) GKI (1.33)
Day 5: BG (3.90 / 70.20) Ketones (2.30) GKI (1.70)
Day 6: BG (4.10 / 73.80) Ketones (3.40) GKI (1.21)
Day 7 : BG (2.90 / 52.20) Ketones (4.60) GKI (0.63)
Day 8 : BG (2.70 / 48.60 ) Ketones (5.6) GKI (0.48)

I also lost 3.5 lbs / 1.6 kg in 8 days. I felt perfectly fine and while I know that every very low blood glucose levels are fine for keto adapted bodies (there was a video by Dr Jeff (?) where he showed that under observation in a research study, the participant glucose levels were dropped to 28 mg/dL without any adverse effects, I am quite freaked out getting this low (Dr Dominik said that 3.5 mmol/dL was normal). Also I had practically zero fatigue, very high energy levels etc. I had actually tracked every single macro as well as Sodium, Potassium and Magnesium level) religiously, so practically no Keto Flu as I loaded up on electrolytes (followed Dr Phinney advice as much as I could). However, on Day 8, I carbed-up (just out of fear and lack of scientific knowledge). I will highly appreciate, if kind folks here could give a word of advice on how to continue without putting my health in danger. Thanks

(Bacon is a many-splendoured thing) #2

I’d be willing to bet you didn’t feel any different, and that the only reason you know your glucose was low was that you were measuring.

As Cahill showed in the 1960’s, glucose can go down to levels that normally cause coma or death in carb-burners, but people are fine, so long as they have enough ketones to feed their brain. I imagine it was the Cahill study that Prof. Volek was describing. The participants were all fasting, so their ketones were quite high. It wasn’t till afterward that the experimenters had a pang of conscience about the risk they had taken, and certainly no institutional review board would allow such an experiment today. But the subjects were quite fine; as Dr. Phinney says, “The only people who were sweating and having palpitations were the ones in the white coats.”

Although Cahill himself estimated that the brain needs 130 g/day of glucose, Prof. Ben Bikman asserts that there is no actual proof that the brain needs any glucose at all, and he has issued a challenge—so far, unmet—for someone to come up with data showing that the brain does need glucose.

(Jake) #3

@PaulL : So many Thanks. Actually, on all levels, I felt so much better. Practically zero drop in energy even after 20 mins of very high intensity cardio. Surprisingly no disturbance in sleep pattern etc. But I like numbers (maybe I should stop tracking). Thanks I will continue with my routine. And make adjustments in my macros (Goal is 5% carbs, 15 % protein and 80% fats) all adding up to 1500 cals and I am experimenting a lot with protein and fats ratios.

#4

Glucose in the 4-5 range is not low - just lower than most people eating a carb-centric diet ever see. As @PaulL mentions, even sub-4 is not necessarily low when you’re ketogenic. And you confirm that you felt just fine whatever it was. Keep on keeping on. :+1:

#5

Why restrict calories?

#6

What time of day did you measure? The sub 3 mmol BG readings are in fact very low after only a week of keto.

Also, what hour of the day did you eat?

(Jake) #7

@Belisarius : Great. I feel much more confidant now to keep on going with this wonderful lifestyle. So many Thanks.

(Jake) #8

@saphire : Taking cues from Dr Phinney when he started his Keto journey 35 years ago, he restricted himself to 1500 calories. I am at 197 lbs with 30% body fat, so essentially the goal is to follow Ketogenic diet combined with caloric restriction as long as I feel fine and can continue to run and lift weights. Also tracking calories allows me to adjust the macros.

(Jake) #9

@Jamesbrawn007 : Actually I put in 6 weeks of “prep work”. Started by switching to 2 meals (High carb) and then gradually to one meal (still high carb with fruits etc) and a smoothie. Eliminated the smoothie. Then started to get rid of some complex carbs slowly. Once I got to a point where my body was adjusted to one meal, only then I dropped the carbs to < 20 gms and switched to strict tracking of macros. Now carbs come from greens only, avocado and cream (in coffee). I did not track calories in my prep days but just ate enough, so that there was no hunger or cravings.

(Jake) #10

@Jamesbrawn007 So I did the workouts in early morning (6:00 AM) and only had black coffee and some electrolytes in water. I would take all measurements at noon (body weight, fat%, Glucose and Ketones) and have my one meal. Also since I was meal preping daily, I could not get precise 1500 cal, so some days it went down to 1100 cals, but I did not want to change the macros and also liked the taste. Dr Phinney has a great article 10 Principles of WFKD, so built my meals around that (except his advice is to not track macros – although he mentions that he dropped to 1500 cals when he switched to Keto, plus the sample tables he provides all have calories tracked (so there is a bit of contradiction there), so I decided to combine the best of both worlds as I do not trust my intuition or body signals totally.

#11

That explains the low BG/high ketone readings you provided. I think OMAD is a useful tool, and eating your meal around noon is probably optimal instead of in the evening (which I habitually do although I am not as late as I have been historically).

In terms of kcals, despite what some folks may say, it can be quite easy to overeat on a KD. A typical example was last week where, after my two daily meals, I worked out I had consumed a paltry 1400 kcals and could have easily called it a day after that. However, I opted to snack a bit and after consuming some cheese, salami and dark chocolate, that number soared to almost 2400. Very easily done. If tracking keeps you on track - then track.

(Bob M) #12

I think those are low. The lowest glucose I ever measured (an official blood draw) was 62, but that was AFTER 4.5 days of fasting. To get that low after a week of keto is astounding.

(Jake) #13

Yes and that’s what freaked me out too. I had in-fact started to clean up my diet 6 weeks prior and brought it down to one meal a day (still with fruit and carbs) and then switched to < 20 gms / day of carbs and less than 1500 cals per day. Also i think, dailyone hour of intense workout (including 20 min HIIT) played a part too. I strictly followed zero calories rule for 23 hrs. Anyways, I have started back up and will see where I land this time. The overall experience (minus the fear factor) is fantastic though. And i got those numbers on Day 8. (I mean very low sugar and very high Ketones)

(Jake) #14

Also I have a very demanding IT job, so I can not afford energy or focus drops due to fasting. Besides Dr Phinney advises to have three keto meals / day as prolonged fating is related to muscle loss (I think he mentions a fast > than 48 hrs will lead to muscle loss). So i took his advice to some extent (no prolonged fasting) but included intermittent fasting (1/23) model.

(Bacon is a many-splendoured thing) #15

That is very interesting, because for the past five years, every Phinney video I’ve encountered (some of them going back to years before I started keto) has stressed that it’s important to eat to satiety. I suspect that the doctor was not saying that he restricted himself to that number of calories, but that’s what he ended up eating when following his body’s appetite cues.

In any case, it has been well-demonstrated that eating to a target level of calories risks putting the body into “famine mode,” in which it lowers the basal metabolic rate to compensate for the reduced energy intake, and holds on to its fat reserves as long as possible, to prevent starvation. Many forum members have found themselves actually losing more fat while eating more, not less.

(Bob M) #16

He’s most likely wrong. In fact, I was fasting a ton (many 3.5, 4.5 day fasts), and gained fat free mass while losing fat mass, verified by DEXA scans. Now, it is possible I would have gained more muscle mass by not fasting that long, but I’d need two of me for that test.

(Bacon is a many-splendoured thing) #17

I believe it’s fasts longer than three days that concern him. Also, @marklifestyle had a long conversation with Dr. Phinney at the last Ketofest and came away with the impression that Phinney’s opposition to fasting is stronger in public than in private (did I get that right, Mark?).

Also, even Jason Fung says not to fast longer than three days without medical supervision, so he and Phinney aren’t as far apart as it may seem.

(Jake) #18

You maybe right. I have just combined lots of advice from different experts in my plan and monitoring my body signals plus stats. As long as I can safely increase the intensity / volume of my work outs, and my (ordinary) weight scale shows a downward trend and I am eating a widest possible variety of keto friendly foods and have high energy and focus, I am happy. Off course as my body composition changes, I will be adjusting the macros. The plan still is to keep carbs < 20 gm and play around with protein and fat grams, while keeping an eye out for BG and Ketones. Ketone strips are darn expensive, so at some point will stop tracking both glucose and ketones (I have set a 90 day challenge for myself). I am sure that I will hit many roadblocks but so far have managed to stay ahead of any blockers. Dr Phinney 10 Rules for WFKD is my standard blue print to follow (with some minor adjustments)

(Bacon is a many-splendoured thing) #19

They are also inaccurate, and at some point your body is likely to get better at retaining ketones and stop excreting them in quantity.

(Jake) #20

@PaulL : True. Fasting has tremendous benefits as I am sure you know much better than me. For me the goal is to craft a plan for myself where I am building muscle and losing fat. At this stage, the focus is on losing fat and retaining muscle through intense workout and caloric restriction. I will continuously adjust the caloric intake and strive to lift heavier / increase cardio - all within 60 mins daily. If I hit a blocker, I may switch to Alternate Day fasting.