Ketone Levels
The classic 1983 study by Dr Phinney measured the athletes blood BOHB as 1.28 mmol/L at rest[6]. This makes me wonder if there is a "Goldilocks effect" to ketone levels. Too high may indicate too little protein, and poor glycogen stores, that may impair endurance performance. The level required to be ketogenic (hyperketonemia) has been suggested as 0.2 mmol/L measured as the combination of AcAc and BOHB in whole blood as this is slightly above the levels seen in "normal" individuals[7]. Personally, I'd argue this is too low to be considered ketogenic, as this level is seen in people on a high carbohydrate diet after a night's sleep. The book "The Art and Science of Low Carbohydrate Living" calls the range 0.5 to 5.0 mmol/L of blood ketones "nutritional ketosis"[8] The follow on book "The Art and Science of Low Carbohydrate Performance" suggests that BOHB levels of 0.5 mmol/L to 3.0 mmol/L is "optimal"[9], with benefits starting at 0.5 mmol/L and improving to 3.0 mmol/L, but levels above 3.0 mmol/L not producing additional benefits[10]. (It is unclear what research these levels are based on.) For epilepsy, the recommendation is for AcAc to be 80-160 mmol/L as measured by urine dipstick[11], though this level is not necessarily sufficient[12]. The range of 2 to 7 mmol/L[13] or 2 to 5 mmol/L[14] has been suggested in some literature as a "therapeutic" range. A study of 74 children on the ketogenic diet for epilepsy found that blood BOHB levels of greater than 4 mmol/L were correlated with better seizure control than those with lower levels[12]. A 28 day study of five Parkinson's patients on the Ketogenic Diet had blood BOHB levels averaging 6.6 mmol/L (range 4.8 to 8.9) and showed some signs of improvements, though the study was too small for any conclusions to be drawn [1 Continue reading >>
How To Read Blood Ketone Test Results
If you are living with diabetes, chances are you've probably had your blood or urine tested for ketones. When your body doesn't have enough insulin to absorb glucose it breaks down fats for energy, creating ketones as a byproduct. Everyone produces ketones, but if you have diabetes, you have a greater risk of ketones building up in your blood, which can lead to diabetic ketoacidosis. Both people with type 1 and type 2 diabetes can develop diabetic ketoacidosis. That said, it is more common in people with type 1 diabetes. Interpreting Your Blood Test Results Ketone blood testing is the preferred method for assessing the presence of ketones during times of sickness. Urine test strips can be used, but the American Diabetes Association recommends using blood ketone tests because they are more accurate and timely. Blood ketone tests use different measurements than the numbers you are familiar with on your glucose meter. When using a combination home blood glucose and ketone meter, such as the Precision Xtra Meter by Abbott Labs, or if you have your blood drawn and assessed at a lab, the results will fall into one of the following three ranges: Below 0.6 mmol/L: If your reading is below 0.6 you are in the normal range. 0.6 to 1.5 mmol/L: If your number is in this range you have the presence of ketones in your blood, which may develop into a problem if not treated. You should be in touch with your healthcare provider and follow his or her instructions. Above 1.5 mmol/L: Readings above 1.5 indicate a greater risk for developing ketoacidosis (DKA). You should immediately contact your healthcare provider for advice. Readings above 3.0 mmd/L may warrant a trip to the nearest emergency room for immediate treatment. If you are testing your blood or urine at home and are concerned ab Continue reading >>
Nk N=1 Addendum: Hourly Weight, Blood Glucose And Blood Ketone Testing
I’m coming up on the 9-month update of my n=1 experiment testing the concept of “nutritional ketosis” (NK) this next week, but I decided to do something over the past week as an addendum to the regular testing I’ve been doing. If you’ve been following my progress on this NK journey since I started it in May 2012 (if you missed any of my monthly updates, check out Day 1-30, Day 31-60, Day 61-90, Day 91-120, Day 121-150, Day 151-180, Day 181-210 and Day 211-240), I’ve been testing my blood glucose and blood ketone levels in the morning and at night as well as my weight first thing when I wake up. But just out of curiosity I wanted to up my game a bit and test every hour on the waking hour for one week examining my weight, blood sugar and blood ketone levels. I’ve noticed during my experiment that my ketone levels tend to be lower in the morning and higher at night, but I didn’t know what was happening in the hours throughout the day and wanted to know. Plus, I’ve been wondering what was going on with my blood sugar after meals and exercise. And just for fun (because the fluctuations that happen throughout the day are pretty much irrelevant), I tested my body weight fully clothed every hour as well. My poor fingers took a pummeling with about 20 finger pricks a day on average (sometimes the lancet didn’t go deep enough to produce enough blood with just one finger prick), but this information was totally worth the temporary pain. Let’s take a look at what happened along with a few observations: DAY 1 – SATURDAY, JANUARY 26, 2013 Fun first day of testing. My blood sugar ranged from 70-94 (AWESOME!) with the greatest rise predictably after eating. Even still, the increase in blood glucose wasn’t that pronounced (predictable considering I’m eating v Continue reading >>
Ketones And Exercise – What You Need To Know
A researcher on diabetes and exercise describes why exercise elevates risk of DKA for people with Type 1 diabetes. In a new set of guidelines for Type 1 diabetes and exercise, I and my fellow researchers warn that people with Type 1 diabetes need to monitor for elevated levels of ketones during exercise. If you have Type 1 and exercise regularly, testing for ketones could save your life. Ketones develop in our bodies when we mobilize fat as fuel. Fat is an important energy source that is used by the body at rest and during exercise. Ketones are a general term in medicine used to describe the three main ketone bodies that the liver produces – acetoacetate, beta-hydroxybutyrate, and acetone. Read “Too Many with Type 1 Don’t Test for Ketones.” sponsor Ketone bodies help fuel the brain and skeletal muscle during times of prolonged fasting or starvation, so in a way ketones are very important for survival. We actually have enough stored fat to generate energy for days, but this can cause a number of metabolic problems, the most important of which is ketoacidosis. In Type 1 diabetes, ketone levels can rise even without starvation, if insulin levels drop too much and levels of other hormones like glucagon and catecholamines rise. This rise in ketone levels in diabetes can cause a life-threatening condition called diabetic ketoacidosis (DKA). Read “How DKA Happens and What to Do About it.” The symptoms of ketoacidosis include: A lack of energy, weakness, and fatigue Nausea and vomiting, stomach pain, decreased appetite Rapid weight loss Decreased perspiration, foul or fruity breath Altered consciousness, mild disorientation or confusion Coma sponsor The reasons for developing high ketone levels in Type 1 diabetes include: Missed insulin injections Failure of insulin Continue reading >>
What Are The Optimal Ketone Levels For A Ketogenic Diet?
If you’ve just started a ketogenic diet, then you’ll know that it can be really tough to figure out if you’re doing keto right. Am I eating too many carbs? Too much protein? Should I still be feeling tired? When is the fat burning supposed to start? It’s confusing, and one of the most confusing aspects is what your optimal ketone levels are supposed to be. Unlike most other diets, the ketogenic diet is designed to put your body into a state of ketosis in order to get your body to start burning ketones instead of the glucose that it usually burns when you eat a high carb standard American diet (SAD). But to know whether you’re in ketosis and whether your body has enough ketones circulating for you to use as energy instead of glucose, you have to measure your actual ketone levels and then determine whether they’re high enough for you to be reaping the benefits of the ketogenic diet. If you’ve tried searching for this information already, then you’ll know that there’s some controversy depending on which expert you follow. So in this article, we’ll tell you exactly what the different experts are suggesting are the optimal ketone levels as well as give you recommendations for what ketone levels you should be aiming for depending on your goals with a ketogenic diet. A Few Quick Notes Before We Start… If you’re looking for signs other than testing your actual body ketone levels as to whether you’re in ketosis or not, then please check out this article instead that provides you with signs you’re in ketosis. If you’re a type 1 diabetic, then this article is not for you and the optimal ketone levels suggested below are not applicable to you. Please check out the tons of other ketone level articles on the web to ensure your ketone levels do not reach Continue reading >>
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
- World's first diabetes app will be able to check glucose levels without drawing a drop of blood and will be able to reveal what a can of coke REALLY does to sugar levels
- Does the Ketogenic Diet Work for Type 2 Diabetes?
What Is “nutritional Ketosis”?
IN A NUTSHELL: Nutritional ketosis is a state of health in which your body is efficiently burning fat as its primary fuel source instead of glucose. When undergoing a ketogenic diet you are essentially converting yourself from a “sugar burner” to a “fat burner”. This is accomplished by reducing your consumption of carbohydrates, increasing your intake of fat, and consuming only an adequate amount of protein to meet your body’s needs. The term nutritional ketosis is claimed to have been coined by Dr. Stephen Phinney & Jeff Volek, two of the leading experts and researchers in the field of low carbohydrate dieting (Check out this informative video to hear a talk from Dr. Phinney). Ketosis is achieved by following a “ketogenic diet” which is high in fat, very low in carbohydrates, and adequate in protein (Please Note: It is “adequate” in protein, NOT “high” in protein. More on this later). By consuming more lipids you are enhancing your body’s fat burning function by up-regulating the enzymes and other “metabolic machinery” needed to burn fat more efficiently, therefore making it easier for your body to tap into stored adipose tissue as an energy source (i.e. you turn yourself into a fat-burning machine!). But don’t we NEED carbohydrates? While it’s true that our red blood cells and a small percentage of brain cells and kidney cells are exclusively glucose dependent, the body can actually GENERATE carbohydrates in a process called gluconeogenesis in which certain non-carbohydrate substrates like proteins (amino acids) and certain constituents of fatty acids (glycerol) can be converted into glucose. The quantities of glucose produced by the body are sufficient to meet the needs of these particular cells and also help to balance the body’s bl Continue reading >>
- Reversing Type 2 Diabetes with Nutritional Ketosis
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
An Inconvenient Truth About Ketone Levels
Too many keto "gurus" make bold, one-size-fits-all claims about ketone levels. Learn how to separate truth from myth! If you've been following a ketogenic diet for a while, or spent any time frequenting forums and blogs dedicated to this way of eating, you've probably figured out by now that nutritionist JJ Virgin nailed it: The human body is not a bank account, where you can make precise deposits or withdrawals and know exactly what your balance will be afterward. If only it were that simple! The success stories and frustrated rants on various keto platforms across the internet point to something that should be fairly obvious: People are different. (Shocking, I know!) Two people can eat the exact same number of calories, in the exact same macronutrient ratios, and even eat the same exact foods, yet have completely different ketone levels, energy, and fat-loss results. The widespread existence of keto myths makes adapting and thriving more difficult than it should be for newcomers to keto. Learn the truth about these four common keto myths to calm your ketone (or lack thereof)-induced stress! Myth 1 Higher Ketones Lead to More (or Faster) Fat Loss If there is one myth I wish would die a fiery, painful death, it's this one. Why? Ketone production is the result of lipolysis (the breakdown of fat)—not a direct cause of fat loss. This applies to blood-, breath-, and urine-ketone levels. To further refute this erroneous claim, think about this: It's possible to have elevated ketones and gain body fat. Trust me, you could mainline mayonnaise and nothing else to the tune of 8,000 calories a day and be in ketosis. I wouldn't place a bet on you leaning out much, though. Fat loss doesn't come from being in deep ketosis; it comes from choosing the right foods in the right amount Continue reading >>
The Importance Of Checking For Ketones
The information contained in this article is provided for educational purposes only and is not intended to replace veterinary advice. Please consult with your vet for further information. Ketones occur when the body cannot access blood glucose for energy. Untreated ketones can lead to a life threatening situation, a diabetic keto-acidosis or DKA. A DKA is an emergency situation, and vet care is essential. Catching ketones at low levels and taking appropriate action can save your cat’s life. It is important to test for ketones if your cat is over renal threshold (225-250/12.5-13.8 for most cats). Ketones are a direct result of hyperglycemia (high BGs). Ketones can develop because of not enough insulin, too much insulin, illness, infection, and/or anorexia. What are ketones? Normally, cells get the energy that they need to function by using blood glucose. Insulin plays a vital role in the process: it is the key that unlocks the receptors on cells, letting them access the needed glucose. Cells are unable to do that when there is either insufficient insulin, or when insulin resistance has built up and the receptors are no longer receptive to the insulin present – the key doesn’t unlock the cell. As it can’t find its usual source of energy, the body turns to the next available source and starts burning up muscle and fat for energy. The liver responds to the situation by secreting ketones and glycogen (pushing glucose levels higher in the process). When the level of ketones is too high to be used, they start building up in the blood stream. As this continues, the ketones end up being too much for the body to absorb, and spill into urine. At the same time, they upset the acid balance in the body, leading to imbalances in electrolytes .. and, if left unchecked the resul Continue reading >>
Blood Ketones
On This Site Tests: Urine Ketones (see Urinalysis - The Chemical Exam); Blood Gases; Glucose Tests Elsewhere On The Web Ask a Laboratory Scientist Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, the American Society for Clinical Laboratory Science (ASCLS). Click on the Contact a Scientist button below to be re-directed to the ASCLS site to complete a request form. If your question relates to this web site and not to a specific lab test, please submit it via our Contact Us page instead. Thank you. Continue reading >>
Ketones In Blood And Urine
Ketones are a chemical compound produced by the body to provide energy from the breaking down of fats and protein. The production of ketones is usually a natural process but people that require insulin doses, such as those with type 1 diabetes, need to be aware that high levels of ketones can quickly lead to a very dangerous condition called ketoacidosis. Who should test for ketones? People who should test for ketones are people that make very little of their own insulin. This commonly includes individuals with: Type 1 diabetes LADA diabetes who are on insulin Type 2 diabetes who have decreased beta cell function, or people who have had a pancreatectomy (surgical removal of the pancreas) Why are ketone levels important? Ketone levels rise when cells in the body need energy but there is not enough insulin in the body to let glucose from the blood into those cells. As a result the body turns to metabolizing fats and proteins to form ketones to use as energy. If the body needs to convert energy in this way for an extended period of time, it can cause higher levels of acidic ketones to develop in the blood and have a toxic effect on the body, resulting in a dangerous condition called diabetic ketoacidosis (DKA). People that don’t make enough of their own insulin need to be aware of any instances in which ketones levels are rising too high. When to test? It is advisable to test for ketones in the following situations: If your blood glucose levels are 240 mg/dL or more If you develop higher sugar levels when ill If you are vomiting or experiencing diarrhea During pregnancy How to test Ketone tests can be carried either using urine ketone testing strips or using a specialist blood glucose meter that takes blood ketone strips as well as blood glucose test strips. Most urine k Continue reading >>
Ketones Urine Test
Urine ketones are usually measured as a "spot test." This is available in a test kit that you can buy at a drug store. The kit contains dipsticks coated with chemicals that react with ketone bodies. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones. This article describes the ketone urine test that involves sending collected urine to a lab. A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the health care provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly so that the results are accurate. Continue reading >>
What Are Ketones?
What are ketones and what causes them? Ketones are the result of the body burning fat for energy or fuel. For a person with diabetes, ketones are often the result of prolonged high blood sugar and insulin deficiency. Without the right amount of insulin, glucose starts to build up in the blood stream and doesn't enter the cells. The cells burn fat instead of glucose, and ketones form in the blood and spill into the urine. Some causes of high blood sugar are: Missing an insulin dose or skipping some oral medications. A disconnected or blocked insulin pump tube. Being sick with the flu. High levels of stress. Eating more carbohydrates than your medication covers. What are the signs that I should test for ketones? Symptoms of high blood sugar include frequent urination, frequent thirst, blurry vision, dry mouth, vomiting, and fatigue. There are several scenarios that should prompt a test for ketones. If your blood sugar is over 240 mg/dl for two tests in a row. When you are ill. When your blood sugar is over 240 mg/dl and you are planning on exercising. If you are pregnant, you should test for ketones each morning before breakfast and whenever blood sugars are elevated. How do I test for ketones? There are two ways to test for ketones - by testing your urine or your blood. Ketones appear first in the blood stream and are later present in the urine, so testing your blood for ketones is the best way to check for an early problem. To check urine for ketones, you must collect a urine sample or dip a ketone test strip into a fresh stream of urine. After waiting for the time suggested by the ketone strip manufacturer, you compare the color strip to the chart on the bottle. The darker the color, the higher the amount of ketones in the urine. At this time, there are just a few mete Continue reading >>
It Really Is In Your Blood: Glucose To Ketone Ratios
I wrote awhile back about how I felt that I might be going a little mad obsessing over my blood numbers and measuring my blood glucose and ketone levels. This is one of the greatest differences, in my opinion, between people that follow a ketogenic or low carb lifestyle for overall health reasons or weight loss, and those of us who are experimenting with using a ketogenic approach as a specific disease therapy. I’m using the term “therapeutic ketosis” now for this, as you’ll know if you’re a Constant Reader here at Greymadder. I think people in the first category, with weight loss or general health goals, can definitely be helped by measuring ketones, and that this is vital to the success of the approach. However, in my personal experience using this approach to “starve” my brain tumour, I find I can become quite the data junkie, measuring blood levels of both glucose and ketones up to four times a day, because in my mind, the optimal levels of both are perhaps what’s required to have a therapeutic effect. I base this on the book Cancer as a Metabolic Disease by Dr. Thomas Seyfried, in which he advises that there is a window of effectiveness of therapeutic ketosis for cancer that uses a glucose to ketone ratio of 1.0. This essentially means that when measured in mmol/L (“millimolar”), blood glucose and ketones should be equal, or even achieving ketone levels that are higher than the glucose levels may be preferable. There is general agreement between my favourite go-to references (Ellen Davis, Dominic D’Agostino, Miriam Kalamian, all found in my Resources section) that this glucose to ketone ratio of 1.0 is best. Miriam Kalamian, in her ebook Get Started with the Ketogenic Diet for Cancer further notes that it should not be disregarded that a thera Continue reading >>
- World's first diabetes app will be able to check glucose levels without drawing a drop of blood and will be able to reveal what a can of coke REALLY does to sugar levels
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
- 6 Signs Your Type 2 Diabetes Might Really Be Type 1
Tracking Blood Ketones: Behind The Scenes Data On The Ketogenic Diet
Tracking Blood Ketones: Behind the Scenes Data on the Ketogenic Diet I’ve tried a lot of diets. I first went vegetarian, then slow carb, then gluten-free, then Paleo. I even did a 28-day Chipotle diet, which is exactly as awesome as it sounds. Eventually I found the Ketogenic diet. For me, like for many people in our communities, this all started with a health concern. I was born with a heart condition. It never impacted my life, but it was there, lingering. When I was a junior in college, a few classmates and I were out enjoying late night pizza. Out of nowhere, one classmate suddenly jolted upright and fell off his stool. He died. I found out the next morning it was from a lingering heart condition, not too unlike my own. I started to think about my health a lot more after that. I read about nutrition and started exploring the confusing world of diets. As I learned more and as I became more involved in Quantified Self, I found myself wanting to quantify these diets. That’s what drew me to Keto. It’s the most measurable diet. Quick Summary of the Ketogenic Diet Keto is a high-fat, very-low-carb diet, usually with 70% of calories coming from fat. The idea is to switch your body from using glucose as its primary energy to breaking down fats into ketones for energy. You can measure the macros that you eat and you can measure the ketones in your urine, breath, and blood. In 2013, I did my first experiment with the ketogenic diet. In that experiment, I tracked everything I ate in MyFitnessPal and compared it to other data I was collecting. I found my energy increased, my sleep quality went up (according to my Zeo data), my cholesterol levels improved, and my food cravings went away. However, I also found that measuring everything I ate was a pain, I didn’t really kn Continue reading >>
Ketone Bodies (urine)
Does this test have other names? Ketone test, urine ketones What is this test? This test is used to check the level of ketones in your urine. Normally, your body burns sugar for energy. But if you have diabetes, you may not have enough insulin for the sugar in your bloodstream to be used for fuel. When this happens, your body burns fat instead and produces substances called ketones. The ketones end up in your blood and urine. It's normal to have a small amount of ketones in your body. But high ketone levels could result in serious illness or death. Checking for ketones keeps this from happening. Why do I need this test? You may need this test if you have a high level of blood sugar. People with high levels of blood sugar often have high ketone levels. If you have high blood sugar levels and type 1 or type 2 diabetes, it's important to check your ketone levels. People without diabetes can also have ketones in the urine if their body is using fat for fuel instead of glucose. This can happen with chronic vomiting, extreme exercise, low-carbohydrate diets, or eating disorders. Checking your ketones is especially important if you have diabetes and: Your blood sugar goes above 300 mg/dL You abuse alcohol You have diarrhea You stop eating carbohydrates like rice and bread You're pregnant You've been fasting You've been vomiting You have an infection Your healthcare provider may order this test, or have you test yourself, if you: Urinate frequently Are often quite thirsty or tired Have muscle aches Have shortness of breath or trouble breathing Have nausea or vomiting Are confused Have a fruity smell to your breath What other tests might I have along with this test? Your healthcare provider may also check for ketones in your blood if you have high levels of ketones in your urine Continue reading >>
