Hi, guys! Been listening to the guys and now the mix for over a year but only just now joined the forums. I’ve been keto since May '18, down 50+lbs, feeling good (would be feeling great if my job had me doing more than sitting on my butt all night) and lately, even with weightloss, when I check my ketones via blood test, it only reads low or Lo. Even after intermittent fasting! Why is this happening? I’ve never seen my numbers over .3mmol but I haven’t really been checking it the past 6-7 months but was recently curious. Two days in a row and nothing registers for me but will for others. I’ve tried a full day fast but I was starving the whole time. I can’t seem to eat enough to give me enough fuel, I guess? I’ve friends who’ve said they couldn’t fast until their second year so I shouldn’t worry but that’s also depressing. Help, please!
When I check my ketones via blood test, it only reads low
What kinds of things are you eating?
How is your sleep, stress, etc?
Are you keeping carbs under 20g?
Fasting happens at different times for everyone. Mostly it just happens naturally, but you do need to make sure that you are eating enough and that you are adapted beforehand. Some people slowly adjust their eating window so it gets smaller before going for a long fast.
Almost everything I eat is either smothered or cooked in butter. I work crazy hours so always being able to keep my carbs under 20gms can be difficult at times but I try to keep is as close to 20 or under as possible. I work 13hr night shifts 6 nights a week and have to cook for myself when there’s room and dishes appropriate for cooking my food as my newly adult kids still live at home and their diet couldn’t be more opposite to mine. I did eat just steak and butter last night and upon checking my blood sugar and ketones withing an hour of eating it, I finally got a level. BS 83, which it usually is, ketones .3mmol. I think eating broccoli and cauliflower is causing a bit of the problem so I may need to stick to mostly meat and fish swimming in butter. Also, being a nurse, I’ve been working with this diet for nearly 15 years now but only considered that it could work for me, too. And my moods have been fantastic since starting last year, no more serious pain issues, etc.
So are going to enjoy the results you’ve so far accomplished, or worry about numbers on a meter? You are fine.
Welcome to the forum, Melissa. You are doing great with your Keto, don’t worry so much about what others are doing. Everyone has their own personal way that works for them with Keto.
I think you are doing well. It could be the stress from the hours you are working. I’m sure someone else here could add their experience. But, even 0.3 is something! If you really feel you need your ketones higher you could try adding in some MCT oil (or powder) as an experiment.
Nurse here. I also work crazy hours. Heck today I do an 8 hr at one job. Leave and do a double at another… I get it! This is why I did the slow steady route. IF since March/April of 2018. Keto since about May/June 2018. And I started off just doing 12:12. Now I am OMAD 21-24. Slow and steady when I was ready.
Started off just doing low carb. Not even keto. Just took out bread. Then all forms of grains. Did one meal at a time of low carbs. Progressed to low carbs for all meals. Graduated to keto albeit dirty. Then strict keto. Now I am mostly carnivore. Eventually I got the result I wanted. I look the best at 43 than I ever did at 23. And feel much better. I get alot of people who want my results…but a year ago I was where you are. I wanted those results from “those” people. I had to stop comparing, and do things in my own time. BTW… I don’t even register ketones anymore.
Thanks, guys!! I think I’m gonna focus on sticking to meat and butter. Seems to work for me but I do kinda miss veggies. Curious, does anyone else here have Narcolepsy? I’m wondering if that has any effect on how I metabolize my food. Also have the thyroid issue, but that’s not even a thing with how many people have it, too.
Here’s a test for ketosis that doesn’t require a meter:
- Is your carbohydrate intake under 20 g/day?
- Are you breathing in and out?
If you answered yes to both those questions you are in ketosis.
Seriously, there are a number of reasons that a meter might not be registering ketones, even though you are producing them. For one thing, your meter might be out of calibration, for another, your strips might be bad. I wouldn’t particularly worry about your level, as long as you continue to feel the benefits of being in ketosis.
Do you mean you take blood ketones measurements and get low or zero, or do you mean you don’t take ketones? I’ve moved to the latter (not taking ketones), though I still use my ketonix daily, just for kicks. But over the course of 4+ years, my levels on the ketonix have dropped, as they did with all my ketones. I used to get 70+ all the time on ketonix years ago, and now the highest I’ve seen was 75, but that was after 4.5 days fasting, then a super-high-fat refeeding to do a Dave Feldman Cholesterol drop. And on the first day. Then on Monday after three days of high fat feeding, I was back down to 31 again.
So, I look more for whether I’m progressing or not.
As I understand it, in the beginning ketones are high because your body doesn’t really understand them. Then suddenly, your body ‘gets it’ and starts to use them efficiently, so the blood levels drop. This is fat adaption!
I’ve never taken exogenous ketones if that is what you mean. What i mean is I used the urine dipstick, I know it’s not the most reliable but that is what I have at work.When i first started (and much bigger) I was happy to see proof when I started to see the high ketone number on the stick. When I check now, nothing shows up. I am not going to get a meter. now that i am uber lean, I don’t see the point for me. Maybe when I first started I wanted to get a meter, just never did. But heck, my abs are on fire. I don’t need a stick to tell me I am burning fat for fuel anymore. I must just be using all my ketones and not wasting any at all anymore if nothing is showing. That’s my own reasoning and I am sticking to it! And yes, the few times i do measure…I get ZERO.
That makes sense. The pee sticks, I gave up on them years ago, for the same reasons you see: they don’t work after a while.
I keep doing breath and blood ketones for a long time, to try to test what would happen, say if I ate more protein and less fat. But the problem I had was there are too many sources of error: measurement error; time of measurement error; eating not exactly at the same time; eating different fats/proteins; hydration errors; etc. After years of testing, I realized that I couldn’t really verify or quantify anything with any accuracy, so I gave up.
Now, I just go by belt sizes. The belt I’m currently wearing, for instance, needs to be tossed: it’s too big on me and there’s no additional hole. Or I go by other indicia, such as how I feel, look, etc.
Curious. I’ve had a few seizure patients on this diet and I’ve seen different ketone results between them. I’ve had some on the diet via tube feeding (so it’s super precise and strict) for years and they’ll still register like 40-80 for ketones with a urine dipstick and oddly enough, the little one I care for now, his ketones go from 5-80 randomly. Anyone have an idea as to why? I can’t figure it out. I know that technically, the longer you’re on this diet, you should make just what your body needs so why is it that some people, after years of being on this diet, continue to, I guess, over produce ketones that spill into the urine?
I was just watching a lecture by Jeff Volek, in which he said something in passing about the kidneys getting better at scavenging ketones and putting them back in the bloodstream. I suppose there is a fair amount of individual variation in this regard. I’m not sure we understand all the mechanisms yet.
But as I mentioned in my earlier post, anyone keeping carb intake low and who is still conscious and breathing, has to be producing ketones, regardless of measurements. As for why you are seeing such variation in your patients, have you tested to see what their glucagon and insulin are doing? What is their HbA1C? I suspect the insulin/glucagon ratio is relevant to your observations.
BTW, has anyone mentioned the possiblity of a bad batch of test strips, in your case? That could be another explanation for your low reading.
@Melissa_Coyle Welcome to the forum!
One of the benefits of all this technology (urine sticks, blood meters, breath testers, bloodwork sent out to labs …) is that we get what we want to accept as the plain 'truth" - you know, the incontrovertible “data.”
By the same token, if a low-carb/high-fat eating style is reliably effective, it would be JUST as reliably effective even if none of these measurement devices had been invented. Our body metabolisms remain unaffected by any of those numbers we try to track.
The variability you see in your patients is emblematic of the great diversity of the human race. There’s a wide range of biochemical measures lurking within each of us, and that’s before introducing instrument calibration, device failure, general measurement error, etc.
As for your personal situation, I think @PaulL essentially nailed it here:
To extend his point: If you’re keeping your carbs this low, you’re only getting somewhere around 100 kcal or less daily from carbs. If you weren’t in ketosis by now, you’d fail Paul’s second test… i.e., you’d likely be dead 
Stay the course, and have faith in the science (which you clearly understand well enough to explain to others). As for what the meter says, ultimately it’s not relevant to how well you’re actually doing.
Don’t despair and don’t stray from the path you’ve carved out for yourself. And congratulations for the fantastic progress you’ve made so far!
Everyone is different. Some still turn pee sticks dark after > 1 year on keto and some don’t.
Which ketone blood meter are you using? When I got new strips for my Keto Mojo I forgot to recalibrate with the new chip that came with the strips. I kept getting the “low” readings even though I knew I was in ketosis until I figured it out and ran a cycle with the chip. Got a normal reading after that.