Wife is doing it all correctly, but meter says differently

(johnp71) #1

My wife is so frustrated right now, and I could really use some collective wisdom to help her. We have both been keto since October, starting initially with a blood sugar detox by Mark Hyman in August. She’s lost over 40 lbs since then but has stalled out since December.

Her macros are in check. She’s eating at a pretty significant calorie deficit, about 1000 per day or less. She only eats 2x per day and when she does it’s all real food nothing processed. Lots of water, one cup of decaf with a splash of heavy cream. Any carbs she eats are incidental from vegetables.

She got a Ketone blood meter the other day and has been checking to see if she’s even in ketosis. First test showed 0.4, next day 1.2, and today 0.4 again. She’s super frustrated, and I don’t know what to do to help her. She also had a blood panel done by her doctor last week that showed no Ketone in her urine.

One other factor to consider is that she has rheumatoid arthritis. Since going keto she feels much better, but she still has weight to lose and seems stuck. Would greatly appreciate some advice from someone who has successfully dealt with this issue!!


There are certainly some variations among individuals, but in the post below I explain a little bit about urine and blood ketones and how some people will see lower numbers than they’re expecting and that might be a good thing.


Above and beyond any testing, feeling better is far more important than any testing.

(Judy Hunter) #3

Maybe try fasting for a few days. That worked for me.

(G. Andrew Duthie) #4

Why is she eating at such a large calorie deficit? One downside to that is that her body may be lowering her basal metabolic rate because it thinks it’s starving. Losing weight with keto isn’t about restricting calories, it’s about eating the right things (and not eating the wrong ones).

I’d consider lowering carbs as much as possible (or at least being sure that no sneaky hidden carbs are creeping in), and raising fat intake to make up the current caloric deficit.

Another possible tactic is intermittent fasting. For me, of late, it seems that if I am eating “normally” (i.e. - multiple meals a day), I have a habit of grazing throughout the day, and even though I am eating keto foods, that seems to be enough to prevent weight loss, and probably minimizes my ketosis.

Just some thoughts to consider.

(Kathy L) #5

I just broke a year long stall after losing 40 lbs. I have at least 40 more to go & even tho I was stalled -I knew if I went back to my old WOE I’d be back to high BP & higher A1C ( am currently down to 5.6 WITHOUT metformin - from 6.2) even though I THOUGHT I was eating keto - and was definitely eating low carb - I struggled to be IN ketosis! A new doctor suggested I really COUNT all carbs I eat. I’m using Cronometer to track & was surprised at all the foods I pretty much thought of as having ZERO carbs- actually had maybe 1-3. Those suckers really add up! Now, after 6 days of close tracking-& staying at 20 (one day still ended up at 24) I’m down 2lbs!! I think I’ve found my problem!! CARB CREEP!!! You could have your wife try using the app - Cronometer to track every morsel she eats. It has a good plan setting for KETO & adds all the carbs for you as well as showing you neat graphics with your daily macros. Oh -and by the way -I wasn’t eating enough fat -even tho I THOUGHT I was! Who knew!

(Kathy L) #6

Many foods say <1 /or 1 carb -but then I’d eat a 1/2 cup & Cronometer counted it as 3! So close tracking CAN be helpful!

(bikeflea) #7

Large calorie deficit can cause her body to “reserve” itself. Eat fat! Follow macros at a higher calorie level. (what everyone else said…) and the fasting… it’s amazing.

(David K) #8

See above. Also, if you’re body is fighting something, your Ketones are going to be lower according to Dr. Nally.


After I saw “calorie deficit” I didn’t want to read any further.

Sorry…I need to see an explanation behind this strategy before offering any advice.

(johnp71) #11

Thank you all for the replies. She’s convinced that she will gain weight if she doesn’t eat so little. I don’t know how to convince her otherwise. Cognitively I get it, but I don’t know how to say it in a way that makes sense.

(Sarah Roeder) #12

Sometimes hearing it from another source is helpful; I’d suggest Dr. Fung’s book The Obesity Code as a good resource to share with her. It’s an excellent book that addresses (among other things) why calorie reduction isn’t the best approach. Good luck to you both!

(Scott Shillady) #13

Here is a great post by @richard that illustrates the CICO myth

What my dog taught me about CICO