Ketone Levels

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Not to be confused with Ketoacidosis. Ketosis is a metabolic state in which some of the body's energy supply comes from ketone bodies in the blood, in contrast to a state of glycolysis in which blood glucose provides energy. Ketosis is a result of metabolizing fat to provide energy. Ketosis is a nutritional process characterised by serum concentrations of ketone bodies over 0.5 mM, with low and stable levels of insulin and blood glucose.[1][2] It is almost always generalized with hyperketonemia, that is, an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis when liver glycogen stores are depleted (or from metabolising medium-chain triglycerides[3]). The main ketone bodies used for energy are acetoacetate and β-hydroxybutyrate,[4] and the levels of ketone bodies are regulated mainly by insulin and glucagon.[5] Most cells in the body can use both glucose and ketone bodies for fuel, and during ketosis, free fatty acids and glucose synthesis (gluconeogenesis) fuel the remainder. Longer-term ketosis may result from fasting or staying on a low-carbohydrate diet (ketogenic diet), and deliberately induced ketosis serves as a medical i Continue reading >>

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Popular Questions

  1. Emacfarland

    I'm confused about what defines being in nutritional ketosis based on blood levels. The Diet Doctor website says 1.5 is considered ketosis while I've heard on Keto Talk from Doc Nally that fit and active people can be in ketosis at levels of .3 or .4 and that higher levels don't necessarily mean better. So I'm not sure what the heck I'm aiming for! If I get readings below 1.5 am I doing something wrong? I am fit and active and Doc Nally has said this can make blood ketone level readings lower because an active persons body is using the ketones more efficiently. Should I be aiming for higher levels?

  2. BillJay

    It seems that the longer someone is keto-adapted, the more their body produces just the right amount of ketones and what we measure in the blood is only what's not actually being used, therefore it seems not only possible, but likely that people are in ketosis even with lower betahydroxybutyrate (BHB) levels - the ketone in the blood that these meters measure.
    This is somewhat frustrating for me since I'd like for there to be an objective measurement of being in ketosis, but that seems to be elusive.
    Therefore, a better indication is your level of carbs since it is HIGHLY unlikely that anything over 50 carbs is in ketosis and more likely that keeping carbs under 20 grams is a safe bet. Another indication is keeping protein at moderate levels which is 1.0 to 1.5 grams per kilogram of lean body weight.
    Once the macro-nutrients are in the proper range, I think that signs of keto-adapation are more poignant and below is a post from Mark Sisson on Dr. Mercola's site that explains many of the signs of being keto-adapted.

    What Does It Mean to Be Fat Adapted?

  3. richard

    Dr Phinney invented the term so he gets to define it.
    In his book "The art and science of low carbohydrate living" he gives the range from 0.5 to 3.0 mmol/l
    But recently he mentioned that some of Dr Volek's very athletic subjects were clearly in ketosis at 0.2 mmol/l.
    My personal range is from 0.2 to 0.8 mmol/l, and I have been in ketosis for almost 3 years. Prof Tim Noakes is also normally in the same range 0.2-0.8.
    I suspect when we first start we aren't good at using them so we make too many and use too little so we end up with a lot left in our blood. After we become better adapted we end up in whatever physiological range our bodys feel best ensures our survival. And people who are trained and good fat burners may be able to get away with less because they can make it easily.
    When I fast for 3 days and then do 3 hours of exercise my ketones can go as high as 3.5. But I know people who regularly get up to 7.
    It's worth pointing out that Dr Nally has mentioned in his most recent podcast that he eats exogenous ketones 3 times a day. And he sells them.

    Personally I wouldn't be worried. I think you are doing fine.

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