Ketone Levels

Hi all, I have been testing my fasting ketone/blood glucose levels every morning around the same time. I can't seem to get below 4.0-5.3 mmol for ketones and BG is anywhere from 140-160. I am type 2 diabetic with about 60 lbs to lose. This is with not eating anything after 7pm except magnesium before bed. I generally have 1400-1500 calories with <25 carbs (no fruit/grains/high carb veggies),665-80g protein, and 109-120g fat. Am I not eating enough calories or what? I have read so much conflicting information in both directions as to the ketone levels. Read somewhere over 3.0 was acidosis and needs immediate medical attention to over that is starvation. If 3.0 and under is optimal, then how the hell do I get there? Obviously I'm making ketones and in a ketosis state. Could someone enlighten me please? Thank you!
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  • Which medications are you taking?


  • Why don't you take metformin if you're Type II?  Lots of low carb people take it, fix their blood sugar and then get off it.  


     


    It's not possible to say what your calorie load is.  I would take your weight, and multiply by 10 and use that as your starting point to lose weight.  It's not an exact science but if you want to track calories that's where I would start.


     


    BTW - for Type II, a lot of the science says that intra-muscular fat is contirbuting heavily to the insulin resistance.  That's fat deposits in the pancreas and liver.  If you create a strong enough calorie deficit, it will eventually be metabolised and your insulin sensitivity can return.


     


    This is why even high carb, low fat diets, fasting diet, bariatric surgery can all "cure" Type II diabetes.  A big deficit in calorie burns the fat in the liver, pancrease etc. and insulin resistance can go away (unless you over eat and build up fat there again).

  • @jason my kidney function seems fine. Urine is lighter than lemonade, I drink at least 120 oz of water daily besides 2 cups of BPC every morning,no stones,no pain. They seem to be fine. @vkhare I'm trying to control things with diet. My BS was around 260 fasting before I started my journey in January. I've been BP-ing about 2 weeks or so and combined I've lost about 40lbs. My numbers above are WAY better than what they were before I started. I am currently at 194. At 5 foot 5 I need to be about 125-140 ish. That said, I still have a lot of lbs to lose and uunfortunately I carry it in the midsection. Will probably take me a while to to get there. But what about the ketone levels? That was really the focus of my question
  • @Michelle - wow - that's pretty amazing.   


     


    And yeah, no one bothered to answer your question :-)


     


    About ketone levels, I've never had very good luck with getting into ketosis through simple carb restriction or manipulating protein/fat numbers.  What did work for me was:


     


    - Stay less than 50grams of carbs for several days


    - Do some intense activity on an empty stomach - (something resistance based - air squats, walking lunges or even cycling)


     


    I think the exercise on an empty stomach burned off any liver glycogen.  



    According to dietdoctor.com the optimal levels are 1.5-3.


     


    http://www.dietdoctor.com/category/science-and-health/ketone-measuring

  • Michelle, are you testing at other times during the day? I have been using the Ketonix device for a couple of months now and find better readings at the 14 to 16 hour mark of carb restriction. My dinner is usually around 7 to 8pm, and I have my first BPC around 530am without any breakfast, and testing at the 10am or 11am mark is where my readings improve. I have also found where the tipping point is for raw cacoa in my BPC is to drop my numbers, which could be expensive testing blood.


     


    Are you having your two cups of BPC in one sitting or one morning and one late morning to afternoon? I give myself a five hour spread normally with good results.


     


    My final question is, have you tested regular MCT oil versus c8(brain octane) for ketone levels? My first run with brain octane I did not notice a difference, but also had no testing method. Recently I have been alternating MCT oils and am certain the c8 raises my levels better than standard MCT.


  • @vkhare....thanks! I do 10 minutes of HIIT before I break my fast. I'm for sure in ketosis since I am registering ketone levels on the meter, I just can't seem to get them in the so called "optimal" level. Am I taking in too much brain octane or coconut oil since this speeds up ketone production? In my BPC (2 cups) I only use 1tbsp of brain octane, 2tbsp grass-fed butter, 1tbsp of virgin coconut oil (love this so much I eat it by the spoon full at times), and a few drops of stevia. As for my carbs, they are less than 25. I'm pretty strict with this. Thanks for the tips.
  • @snap....I do not test at anytime during the day. I've read that ketones are lower in the am and higher in the pm, so I don't bother. Not only that, the strips are expensive. I usually have my 2 cups over an hour period. I just sip. I also started to put Ceylon cinnamon in my coffee. Fantastic stuff btw ;-) Brain octane and coconut oils are supposed to get you into ketosis faster and speeds up production of said ketones. I'm in ketosis, so with my numbers being 4.3 to as high as 5.4 I'm wondering if I'm taking too much. I don't need to speed up ketones. May have to either cut back on brain octane or just use coconut oil in my coffee to see if that helps since it isn't as strong as the octane. Any thoughts on this? Thanks!
  • NickatNickat
    edited February 2015

    There is no long term study as yet (that we are aware) that shows the use of cinnamon as an effective method for treating diabetes without any side effects. Please be aware of that. 


     


    The studies we have read say that cinnamon in the form of Ceylon is not that effective for diabetes at all. It is only the Cassia type that has shown promise as a treatment for diabetes.


    It`s controversial as the two types are similar but different when it comes to the treatment of type 2 diabetes. Cassia cinnamon often comes with a blend of other fillers and mixtures so be selective if you use that.


    The Ceylon cinnamon is purer as a tree bark in taste but will not treat diabetes by having an effect on glycemic control.


     May we suggest you do further research and perhaps conduct an N=1 on Cassia type for no longer than 3 to 4 months and under supervision from your doctor.


    Your results of controlled numbers of 4.3 to as high as 5.4 are really good. Look elsewhere as to why your getting this from your diet or meds.


     


    With regards to ketones we are going to use a quote from Jason H. that we feel may help you understand why optimal ketosis means very different things to different people:


     


    When they study "ketosis" in the medical literature, it is usually in conjunction with a metabolic/hormone disorder.  There is no standard for Î²-OHB levels and degrees of ketosis, and there are many reasons for why these numbers might be high (or low).  


     


    We sincerely hope that this may help yourself find the best solution for yourself while researching and treating your illness.


  • I'm not using g Ceylon cinnamon to treat diabetes. I simply prefer the taste ;-) So in essence, my ketone numbers could be optimal for me, but not for someone else? I feel great and I'm losing weight. My BS are okay unless I eat higher carb veggies like sweet potatoes. I eat them, but not often. I try to stick with green veggies (Brussel sprouts, asparagus, zucchini and such). Thanks for the insight!


  • Hi all, I have been testing my fasting ketone/blood glucose levels every morning around the same time. I can't seem to get below 4.0-5.3 mmol for ketones and BG is anywhere from 140-160. I am type 2 diabetic with about 60 lbs to lose. This is with not eating anything after 7pm except magnesium before bed. I generally have 1400-1500 calories with <25 carbs (no fruit/grains/high carb veggies),665-80g protein, and 109-120g fat. Am I not eating enough calories or what? I have read so much conflicting information in both directions as to the ketone levels. Read somewhere over 3.0 was acidosis and needs immediate medical attention to over that is starvation. If 3.0 and under is optimal, then how the hell do I get there? Obviously I'm making ketones and in a ketosis state. Could someone enlighten me please? Thank you!




     


     


    Michelle, Just so I understand.


     


    • You have a history of Type 2 DM
    • Your sugars generally run high from 140-160
    • Your blood ketones also run high from 4.0-5.3 mmol/L

    And it seems like your primary concern is that you fear your blood ketones are running TOO HIGH because you've read that the optimal ketone range is under 3.0 mmol/L.


     


    Is this correct?


     


    It's interesting because most of the keto folks out there are actually working to get their blood ketone levels even higher!  I know because I was in the same boat.


     


    Ok, so here are my thoughts in your regard.


     


    Because you are type 2 diabetic and still have endogenous insulin production (I'm assuming this because your blood sugars, while high, are not SKY HIGH, AND you don't mention any history of external/exogenous insulin use), you are not at risk for diabetic ketoacidosis.


     


    So that's one less thing to worry about.


     


    Just for completeness sake, folks in ketoacidosis have blood ketones higher than 10.0 mmol/L... and probably north of 20.0 mmol/L.


     


    Sufficient to say, as long as you're under 10.0 mmol/L, you're ok.


     


    One thing I want to make clear to you is that when you read stuff out there about ketogenic diets/low carb, you need to be sure what you're reading isn't just directed towards folks with normal physiology or athletes.


     


    For example, I don't have a history of diabetes or any other medical condition, so when I write that, I cut my carb intake down to X gm, which brings my blood sugars down to Y, and raises my blood ketones to Z... it doesn't apply to you because you have an underlying disease process.


     


    You have insulin resistance and outright type 2 diabetes.


     


    Folks who are insulin sensitive and without disease and go low carb generally have lower blood sugars AND higher blood ketones, both of which reverse the moment they eat carbs and spike their insulin.


     


    You occupy a physiologic realm where because of your underlying insulin resistance, so that when you go low carb, you have high blood sugars AND high blood ketones.


     


    This is because your body is very insulin resistant.


     


    Your body is having a hard time responding to the insulin you have floating around, so it can't shuttle blood sugar into cells (this is why your blood sugar is high).


     


    Because your body is having a hard time moving blood sugar into the cells, the cells themselves think they're starving so they're pumping out blood ketones to provide fuel for your body (this is why your blood ketones are so high).


     


    Eventually, if you stay low carb long enough, you can reverse your insulin resistance and both your blood sugars will come down, and your blood ketones will also come down a bit.


     


    So keep on keepin on.  You're on the right track.  The fact that you lost 40 lbs is amazing.


     


    Hope this explanation helps!  I know it's a bit long winded.

    Check out my blogs 

     

    www.bjjcaveman.com

     

    www.theketorash.com

  • @bjjcaveman....You are correct! I think that was a great explanation! So, my ketone levels are okay then? Am I still burning fat even though it isn't "optimal" range? Can you suggest anything I might do to lower my insulin resistance? I do HIIT 3x a week for 10-12 minutes before ending my BP intermittent fasting, which I do everyday. Appreciate the help! 237 down to 194 since January 7th is pretty amazing. Must NE doing something right ;-)
  • edited February 2015

    "So, my ketone levels are okay then?"


     


    Yes, your ketones are ok!  They are just high-normal, well below the range of ketoacidosis.


     


    Am I still burning fat even though it isn't "optimal" range?


     


    The fact that you have blood ketones floating around indicate that YES, you are indeed burning fat.  Now the question of whether this is dietary fat (fats you just consumed) or body fat (fat cells in your body) is harder to determine... but the fact that you've lost so much weight indicates that the majority of the fat is coming from your body... so that's great news.


     


    Can you suggest anything I might do to lower my insulin resistance?


     


    Yes.  Just keep on doing what you're doing.  It's taken you all your life to get to this point where you are insulin resistant and type 2 diabetic.  


     


    Since you've only been doing this since January (losing 40 lbs in the span of 2 months is pretty unreal!), it's only been two months... it will take more than 2 months for your body to correct itself... 


     


    In some folks things get back to normal in a few months, in some folks a few years, and in other folks, they might never make it back to normal... 


     


    Keep at it, you're doing everything you're supposed to, and the results confirm it!


     


    The only thing I'd add is to incorporate more walking and low level activity regularly.  This will help rev up your metabolism and process more of the sugar floating around.


     


    But that's it!


     


    Well done!  You're on your way to becoming the next BP diet success story!


     


    Oh yeah... another thought.  Take a before pic if you haven't done one yet.  It will make the after pic all the more satisfying!  


    Check out my blogs 

     

    www.bjjcaveman.com

     

    www.theketorash.com

  • I thought about incorporating 30 minutes of walking in the early evenings. Maybe before or after dinner. I generally don't eat anything after 6 or so and end my fast around 1:30-2pm. The HIIT is as many jumping jacks for 10 seconds rest 10 for a total of 30 cycles (average is 15 and really push to 18 on last two cycles). I'm getting to where I only rest through one cycle. Big improvement. I only do this Monday Wednesday and Friday for 10 minutes. Maybe adding walking everyday would help. Thanks for the input! I'm a woman, that said I am very hard on myself# ;-)
  • If I have understod the information correct that you have given I'm sad to say it looks like you have type I diabetes. Probably pre type I diabetes is a better term. it's not fullt developed. I would advice you too look this up with an MD specialiced in the matter (internal medicin)

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  • If I have understod the information correct that you have given I'm sad to say it looks like you have type I diabetes. Probably pre type I diabetes is a better term. it's not fullt developed. I would advice you too look this up with an MD specialiced in the matter (internal medicin)




     


     


    Which part of her story makes you think that she has type 1 diabetes?

    Check out my blogs 

     

    www.bjjcaveman.com

     

    www.theketorash.com

  • The sum of ketone and glucose is over 12 ( [blood ketone + glucose] > 12 mmol/L)


    The most common cause of that is DM type I. With that said, this cut of value is not used by standard medical care. They normally analyse each factor by it self and don't account for combinatory influences. They will probably not ring the warning bells until ketone alone is over 10 mmol/L. But it's better to double check this sooner than later.

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  • Type 1 is juvenile diabetes that is detected in young children. The possibility of getting type 1 as an adult is not likely. Most type 1 diabetics live on insulin pumps, because they don't produce any. Type 2 makes too much and can't utilize it. I have never had issues until I was diagnosed with gestational diabetes which turns into full blown. I'm sure I don't have type 1.
  • T1DM used to be called juvenile diabetes, but it was a bit of a misnomer as one forth of those afflicted did not present until adulthood.  I would urge you to get proper kidney testing performed.  Simply looking at the urine color is not accurate enough.  You need to measure the creatinine to albumin ratio.  If you have more than 30 milligrams of albumin per gram of creatinine, it is a good sign that your kidneys are in trouble.


     


    Have you been monitoring your blood pressure?


  • dazdaz today is a good day ✭✭✭
    edited February 2015

    does Type 1.5 fit...

    Test for GAD antibodies,

    (& get insulin & glucose tested at the same time).

    Edit: hi Michelle, have you had your insulin levels tested before...?

    I don't see that mentioned in this thread


    fake it till you make it

  • Yes...BP has been between 135/72 and 123/57. Between those ranges. I test many times throughout the day. No one in my family has type 1 on either side. When I was in my early 20's and started having children the glucose tests they always did were normal for both pregnancies. It wasn't until I was in my mid 30's and about 70lbs heavier and became pregnant with my youngest son. I had gestational diabetes, but after pregnancy everything went back to normal until a few years later it turned into type 2(never lost the weight). Which they said was possible. Type 2 is more to do with weight issues. At 5 foot 5 and 237 I would say that is a huge problem. Should be less than 140. I'm currently at 194. I plan on seeing the Dr soon to have a full panel done and to discuss my health. I know that I will get yelled at for a keto diet, but I don't care if my body is tolerating it. My numbers outwardly have improved tremendously in almost two months. No pain anywhere, paying close attention to reactions of everything (food, exercise, and supplements). I've come a long way in a little under 2 months.
  • Today type I DM actually is more often detected among adults than children.


    The reason for my concern is that in typ II you have high blood glucose and high insulin.


    In typ I DM you have high blood glucose and low insulin. Since the cells starve, they don't get glucose, it's trapped in the blood and cannot enter the cell. The cell belives there is no glucose in the blood and starts to produce ketones. In type II however the high insulin will supress ketone production. In type I insulin is low so ketone production can proceed.


    It's really the correlation pattern between glucose and ketones that reveals what is going on. Have you tested glucose and ketone on a day you eat more carbs?


    There are more situation than type I DM that csuses this pattern but type I DM is the most common cause. There are rare variations of type II DM that also can give this behavior. The thing is that in reality there are much more than two types of DM.


    Regardless of which type you have you are doing the right thing with the diet. But it's important to understand if there is an autoimmune response going on because this kills the pancreatic beta cells.


    I hope I'm wrong because it doesnt feel nice too push negative news on you. But if i was you i would look it up ASAP with an MD.

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  • Well I had a sweet potato the other night with dinner (3 oz salmon and small green salad) and no other carbs and when I woke up and tested ketones/blood sugar the BG was 157 and ketones were 3.8. My problem isn't during the day with elevated BS, it's upon waking that is higher than normal. That day had been the highest in some time. Usually around 145 or so. Compared to 250+ upon waking that is a huge deficit. I did workout that day, so I added the sweet potato for carbs, I don't usually eat them because they are full of sugar. I eat no grains (or rice of any kind), fruits (other than avocados), no dairy, and only grassfed beef or sockeye salmon or cage free hormone free organic eggs. I stick mainly to mainly green veggies. I have been watching how I react to certain higher carb veggies. If it spikes blood sugar, I stay away from it. I have an appointment with my dr next month, so we will see what that reveals. Since we moved it will be the first visit with her, so i'm sure she will order blood work and I will just have to wait for the results! I appreciate the insight!




  • Today type I DM actually is more often detected among adults than children.


    The reason for my concern is that in typ II you have high blood glucose and high insulin.


    In typ I DM you have high blood glucose and low insulin. Since the cells starve, they don't get glucose, it's trapped in the blood and cannot enter the cell. The cell belives there is no glucose in the blood and starts to produce ketones. In type II however the high insulin will supress ketone production. In type I insulin is low so ketone production can proceed.


    It's really the correlation pattern between glucose and ketones that reveals what is going on. Have you tested glucose and ketone on a day you eat more carbs?


    There are more situation than type I DM that csuses this pattern but type I DM is the most common cause. There are rare variations of type II DM that also can give this behavior. The thing is that in reality there are much more than two types of DM.


    Regardless of which type you have you are doing the right thing with the diet. But it's important to understand if there is an autoimmune response going on because this kills the pancreatic beta cells.


    I hope I'm wrong because it doesnt feel nice too push negative news on you. But if i was you i would look it up ASAP with an MD.




     


     


    My only thought here is that in someone who is insulin resistant, the whole insulin turning ketone production off mechanism doesn't quite work as well as in someone who is insulin sensitive.


     


    No matter how high her insulin is... her intracellular environment still won't be able to see it because of the insulin resistance... so her intracellular environment will still interpret the overall environment as being in an energy depleted state, and will continue to pump out ketones as a result.


     


    So in this particular situation, she can have high blood sugars, high insulin, AND high ketones.


     


    From what I've read so far, I feel pretty confident that Michelle is type 2 DM, most telling by the marked improvement in her fasting blood sugars.. which shows that her system is slowly acclimatizing to eating low carb and is starting to regain it's insulin sensitivity.


     


    But yes, it's always good to get screened for microalbuminuria, AND get your HbA1c checked.    I'm willing to be that this will have come down quite a bit too.


     


    If your fasting blood sugars are decreasing AND your HbA1c is decreasing AND your body fat is decreasing... then even if your blood ketones are in the high ketosis range, you're doing just fine.


     


    If you're curious about this, you can ask your doctor to add the HbA1c and fasting insulin to your blood draw.


     


    and please... keep doing what you're doing.   You're definitely on the right track and deserve to be applauded! 

    Check out my blogs 

     

    www.bjjcaveman.com

     

    www.theketorash.com

  • Thanks! And I will when I see her next month ;-)
  • Even when I was diagnosed before, the Dr said it was type 2. Not saying I believe everything they tell me, because we all know they can be wrong. I think it's just gonna take some self hacking and tweak as I go. I feel fantastic so far!
  • dazdaz today is a good day ✭✭✭
    edited February 2015


    If you're curious about this, you can ask your doctor to add the HbA1c and fasting insulin to your blood draw.




     


    i second that ^.  & if you can get away with it, also add GAD antibodies as well, to rule out Type 1.5 diabetes (esp. if you can get it for free).


    fake it till you make it

  • BJJcaveman,


    Just wanted to point out that insulin resistens hits different organs differently. So muscle mass might not see insulin but the liver does. There are a number of combination that gives different types of T2DM. If all organ are insulin resistant then you are right. But this only happens in a small amount of T2DM (think its lower than 5%). And when it does it usually ends up with the patient needs exogenous insulin just like T1DM.


     


    Michelle


    What you want to look at is the response on glucose and ketone post meal with carbohydrates. Has that pattern changed over time? Can you get ketone down by increasing glucose? Have the sum of glucose + ketone increased or decreased over time? (you need to convert both to mmol/L).


     


    Regardless of which type you have you are doing a good job with the diet and it might be possible to reverse both type I and II at this stage.


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