Paleo Diet and Paleolithic Diet Questions & Answers

Question

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I have never been able to change a keto stick so I decided to get a blood ketone meter and see how that would work. Does anyone know what reading would indicate ketosis?
The product insert is geared more towards "Danger diabetic! Get yourself to a hospital!" vs. "nah, you're ok". If anyone has any non diabetic experience with one of these devices I'd appreciate any thoughts you might have.

flag	asked May 18 2012 at 15:29 juju 1,934●1●3●9

Didn't Jimmy actually discover this new means of testing himself? The guy's an all-around Renaissance man-genius, if you ask me. – Paleo troll is a troll Jul 17 at 23:05

Rob from ketocure.com · Answer 1 · 2012-05-19 14:05:18Z UTC

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If anyone has any non diabetic experience with one of these devices I'd appreciate any thoughts you might have.

I've used them for years and recommend them. Here's an article I wrote about one particular ketone meter, the Precision Xtra:

Precision Xtra on Ketocure.com

Does anyone know what reading would indicate ketosis?

Ketosis is a matter of degree. It's something that gets higher and lower. Home blood ketone meters measure one of the three ketones that the body uses as fuel, beta-hydroxybutyrate (β-OHB). As shown in the first graph below, in average people, β-OHB can range from trace amounts to about 6 mmol/L. But the graph shows blood levels of β-OHB. Home meters show plasma levels. A blood level of 6 is equivalent to a higher plasma level.

In my own case, over two years of testing, my plasma β-OHB has ranged from 0.2 to 7.7. The 0.2 was on a normal (not ketogenic) diet. The 7.7 was on a 2000-calorie-per-day diet with 90% of calories from fat.

alt text

Source of first graph: Cahill, GF Jr. Fuel Metabolism in Starvation. Annual Review of Nutrition. 2006; 26: 1–22

answered May 19 2012 at 14:05

Rob from ketocure.com
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RobS, this is increbible. Aside from the benefit to your migranes, can you feel any physical difference when your ketones or at 5+? Could you "feel" your ketosis level without a meter (I have one, but I'd like to know if there is any benefit in pushing for higher levels). – borofergie May 19 2012 at 14:21

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Yep. After a while at 5 or 6 it starts to feel like a long term fast -- orthostatic hypotension, extreme lack of energy. There are visible effects too -- hairy tongue, deflated veins. High ketosis has harmful effects and in general I think it should be avoided, but there are a few circumstances where the benefits outweigh the harm: (1) To treat a disease (like my migraines) that doesn't respond to lower levels; (2) as a once-a-year prophylactic against cancer or to treat cancer; (3) to help lose excess body fat quickly (ketosis suppresses appetite). – Rob from ketocure.com May 19 2012 at 15:07

Wow, thanks! I am wondering how high in fat and how low in protein/carbs I will need to go to get into ketosis. I am already at about 80~85% fat, 10% protein and 5% carbs. Total caloric intake is just about my calculated BMR. – juju May 19 2012 at 15:57

Ketosis is a matter of degree. There's no line you cross where you're "out" on one side and "in" on the other. Right now you're at some level of ketosis. If you eat less carbs and protein, your ketosis will be higher. If you eat more, it will be lower. Do you mind if I ask why do you want to be in higher ketosis? What are you trying to accomplish? High ketosis isn't healthy -- over long periods it tends to demineralize bone and cause kidney stones. – Rob from ketocure.com May 19 2012 at 16:59

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Borofergie, if you're happy with your glucose you could just add more fat for calories as your distance increases. If you want to get a little fancier, you could increase amounts of all three macronutrients but keep the "ketogenic ratio" constant. Simplified version: (g pro + g carb) / (g fat). I wonder if your glucose would be even better at higher levels of ketosis. In non-diabetics, the higher the ketones, the lower the glucose. Unfortunately, extreme high ketosis, long term, isn't healthy. There's probably a sweet spot, an optimum level of ketosis for you. – Rob from ketocure.com May 19 2012 at 18:48

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borofergie · Answer 2 · 2012-05-18 15:44:40Z UTC

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I bought a blood ketone meter a couple of weeks ago, and have been testing my ketone levels every evening, as suggested by Volek & Phinney in "The Art and Science of Low Carbohydrate Performance".

The process is similar to a regular blood glucose meter (in fact it is a regular glucose meter, but with special strips), although the ketone testing process requires a little more blood than a BG test.

The meter is very cheap but the strips are expensive, about $3-5 a test, even if you get them through ebay.

The process has been really illuminating for me as I think I've discovered that despite eating <20g of carbs a day, I'm pushing myself out of ketosis by sometimes eating too much protein. It's also interesting to see the lack of correlation between blood ketones and urine ketones (as measured by ketostix).

Jimmy Moore is also doing a similar 60 day n=1 experiment right now.

answered May 18 2012 at 15:44

borofergie
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I read that book as well. I'm just not sure what reading actually indicates ketosis. I have tried a 1:4 protein(g) to fat(g) ratio as suggested in the book "sweet potato power". The formula given says to use 0.36 g of protein per lb of body weight, which is less protein that I am used to eating. – juju May 18 2012 at 15:56

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I can attest to too much protein keeping you out of keto. I was eating 1.5g/lb body weight and never got close to keto - rather puzzled until I cut my protein to 1g/lb BW, and then went into keto. – Bristlebeard May 18 2012 at 17:38

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My first reading on the Precision was 1.1! W00t! Volek indicates that "optimal" ketosis for endurance athletes is between 1.25 to 2.5. He himself lives on <50 g total carbs a day to keep at 2.0. To avoid eating too much protein, try maybe keeping it at between 17-20% (depending on your body size) of your daily diet to start and experiment with your readings from there. If you're eating about about 18% protein, <50 g carbs should get you there. Those who are more active/taller can probably eat a little more at still make the optimal zone. Your reading will go up after exercise, and at night. – Wowza May 19 2012 at 1:00

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@Wowza that's great work! Where does Volek say that he keeps at 2.0? I can't get near those levels at <20g. In fact I think I might be better off upping the carb value a bit, and laying off the protein, or eating even more fat (which is kinda tough with no dairy). – borofergie May 19 2012 at 14:04

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Volek says that in his new book. Upping your carbs will move you towards less ketosis, not more, unless you happen to be running an ultramarathon at the same time. If you can't get in the 1.25-2.0 range on <20g, then you need to adjust your protein % down to about 18. Replace w/fat. If that still doesn't work, you need to eat <2000 cal. At <2000 cal, 18% protein (maybe 15 for less active women), and <20g carb, you should get there in a couple of weeks. If not, up the exercise. Volek like boulder-pushing, but any lifting should do. Also add coconut/MCTs to your diet, as much as possible. :) – Wowza May 19 2012 at 17:33

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Alec · Answer 3 · 2012-05-19 05:23:17Z UTC

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Lucas Tarfur's comments here may be useful.

Also, RobS keeps his beta-hydroxybutyrate above 5.5 on the Johns Hopkins epilepsy ratio.

answered May 19 2012 at 5:23

Alec
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You're right, I did that for about a year (with a few breaks), but nowadays I've found that a lower level works fine. I think the lowest level that gives the desired benefits is the best. – Rob from ketocure.com May 19 2012 at 14:26

Shilpa · Answer 4 · 2012-05-18 15:56:57Z UTC

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Do you mind posting an Amazon link to the meter you use? Thx

answered May 18 2012 at 15:56

Shilpa
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	novacares.com/cwd – juju May 18 2012 at 15:59
	This is the one that I use: amazon.com/Precision-Xtra-Blood-Glucose-Meter/dp/… (it's also called the Optium Xceed in some territories). This is the other meter on the market: amazon.com/Nova-Max-Plus-Glucose-Monitoring/dp/… Remember the cost of the meter is irrelevant, it's the cost of the ketone strips that is expensive ($3-$5 a test). – borofergie May 18 2012 at 16:11

Karl Roberts · Answer 5 · 2012-09-09 08:13:45Z UTC

Hi all,

This is how I do it and it works well everytime...

I keep my protein between 75 - 100% of my lean body weight (lbw) and my carb is 50g or less at all times. Your calories goes up/down depend on your fat NOT protein/carb.

Example:

Name: Bob

170Ibs with 10% bodyfat = 153Ibs (lbw). He will eat between 112 - 153g of protein per day. Calories?... he will eat between 2,500 to 3,000 a day.

Exactly, how much protein will Bob need to eat? Easy, on the heavy training day, he will eat up to 153g, which is 100% of his lbw. Continue with 153g for the next 24 hours. After 24 hours, Bob will go back to 75% of lbw, which is 112g.

The only time your body demands approx 100% of your lbw in protein is on the heavy training day and it lasted up to 24 hours. After that, the body doesn't need as much and will not over-spill any carb from the protein.

So, on a normal day, doing things like walking, shopping, gardening, reading etc... 75% of your lbw in protein will be more than enough. The ONLY time you may eat up to 100% of your lbw in protein is on heavy day.

Cheers,

Any Experience with blood ketone meters?

5 Answers