NK without blood test?

[kayellr]

Is it possible to be reasonably sure that a person is in NK without the blood test? I can't do blood tests right now because my hands are incredibly rough and dry. It also really isn't possible right now because of the price of the strips.

I have a regular glucometer that I used for a while because of pre-diabetes to check BG response - the readings made me very sure I needed to eat quite low carb. Even then I had trouble getting enough blood and often wasted 2-3 strips before getting enough. (even with piles of water ahead of time) I understand that the ketone test takes more blood.

So....are there reasonably reliable ways to be close to sure that a person is in ketosis?

I'm pretty sure I am based on a) rapid weight loss b) no real hunger c) elevated mood d) lots of peeing e) ketone stink first several days f) ketostix color first few days g) percentages and actual grams of protein and carbs would make it difficult not to be in ketosis

Not anyone of those alone would tell for sure, or even the combo with 100% certainty. But is there a point at which those of us who can't do the blood test for some reason can approach being sure within a reasonable range?

[kayellr]

Found at least a partial answer from MerryKate (in a place I should have spotted it earlier)

"Some of us are using a blood ketone meter to track our ketosis and adjust our macronutrients based on the readings. This process is described the the Performance book. While its not necessary, it can be very helpful especially to find carb and protein limits!"

So, I'd like to change my question to: What signs are best used in combination or not to determine that you are in ketosis (in the absence of a blood test)? Are there things other than what I listed? Are there things I listed that aren't relevant, or only relevant when in combination with other signs?

[mizzcase]

I don't know where I read this, but it was in a low carb book or on one of these forums:

When I am in ketosis, it is excruciatingly difficult for me to walk up stairs. 2 days a week I have to go up and down 3 flights of steps to get to different classes, and I always know I'm in ketosis because my legs are just DEAD TIRED by the time I reach the third floor.

Only happens when I'm in ketosis.. I'm in relatively good shape and moderately active, and these stairs never bother me when I'm eating higher carb.

Dunno if this happens to anyone else, but thats how I know I must be doing something right. :-)

[reddarin]

It depends on who you ask:

But the whole point of nutritional ketosis is to be in ketosis and you really don't know if you are unless you test. The Performance book is actually a lot more specific about how to get and stay in NK than the Living book. That is the book that Jimmy Moore based his n=1 NK experiment on and it's the book that I've found most useful in my own foray into NK.

If you're losing and you're happy with your results then you're right it doesn't really matter, but is it really NK? Sounds like Atkins to me and I was pretty successful with Atkins for 11 years. But for me it did stop working to lose after a while.

A pretty emphatic statement about required blood testing. But wrong.

You do not need to do the blood tests to do NK. Regular blood testing is a feature of the Performance book which was written for and directed at athletes. For people that *have* to have the precision that blood testing allows for. Jimmy Moore, since he was mentioned in an abject example of appeal to authority, could have done NK without blood testing but he was publishing his experiment on his blog and without blood tests he wouldn't have been able to document his trial the way he could with tests. And JM was in a very terrible position of regaining weight while tweaking everything he could tweak. He knew up front that he needed the extra data to see why his body was not responding to LC the way it had in the past.

In the Living book, where NK is given its legs, the only mention of blood testing is in a clinical setting directed at healthcare professionals. I know that because when I've argued this point before that is the only part that can be pointed at to shore up blood testing as a requirement for NK.

What are the signs of NK. Really they are about the same as with LC since NK is a subset of LC. Appetite suppression, keto-breath (that may come and go), etc. Your list is a good list except! for the 'rapid weight loss'.

NK does not guarantee weight loss, rapid or otherwise. Getting your carbs, protein and fat (calories - not too low not too high) right while being circumspect about existing health conditions and environmental issues (like stress events et. al.) is what will get the scale moving.

Blood tests are a last resort not a first stop. They are a tool to use when things are not going as expected. Except in a few cases I can think of off the top of my head:

- You don't mind poking your finger and blowing money on expensive test strips.

- You have thoroughly educated yourself about NK, tweaked your macros, exercised the patience of Job and you still have few or no signs of achieving NK.

- You are an athlete and you must have the data that blood testing provides.

- You prefer the immediate feedback that blood testing gives you or you have health issues or Rx meds and you need the accurate feedback right now not 4 to 6 weeks from now.

[zgirl]

Originally Posted by mizzcase

I don't know where I read this, but it was in a low carb book or on one of these forums:

When I am in ketosis, it is excruciatingly difficult for me to walk up stairs. 2 days a week I have to go up and down 3 flights of steps to get to different classes, and I always know I'm in ketosis because my legs are just DEAD TIRED by the time I reach the third floor.

Only happens when I'm in ketosis.. I'm in relatively good shape and moderately active, and these stairs never bother me when I'm eating higher carb.

Dunno if this happens to anyone else, but thats how I know I must be doing something right. :-)

Yes, this definitely does happen to me! I am very active but two flights of stairs and my legs feel like bricks. But I didn't think this was a good thing... in fact, I thought it meant that ketosis isn't right for me. Do you know if this is a permanent state or if it will improve over time?

[reddarin]

It should improve over time as your body gets better adapted at using stored BF for energy. Assuming that you don't have high carb days or do other things that push you out of ketosis.

[kayellr]

reddarin, thank you for the great info.

Originally Posted by mizzcase

When I am in ketosis, it is excruciatingly difficult for me to walk up stairs. 2 days a week I have to go up and down 3 flights of steps to get to different classes, and I always know I'm in ketosis because my legs are just DEAD TIRED by the time I reach the third floor.

Just tried this up and down the basement stairs. While I can't say I'm eager to run up and down some more, I'm not DEAD TIRED. My legs are a bit sore, and I was breathing heavy for half a minute or so, but I'm an out of shape 50+ pounds overweight 55 yr old woman in menopause.

Could it be another sodium/potassium/magnesium thing?

[mizzcase]

Originally Posted by kayellr

reddarin, thank you for the great info.



Just tried this up and down the basement stairs. While I can't say I'm eager to run up and down some more, I'm not DEAD TIRED. My legs are a bit sore, and I was breathing heavy for half a minute or so, but I'm an out of shape 50+ pounds overweight 55 yr old woman in menopause.

Could it be another sodium/potassium/magnesium thing?

Hmm maybe, but not for me I don't think. I eat enough pickles and bouillon to cover the sodium, I drink enough Powerade Zero to cover the potassium, and I take a magnesium supplement.

I'm very stringent about supplementing because I hate, hate, HATE carb flu and get it bad if I'm not aware of those three micronutrients. When I'm supplementing enough, the dead legs are the only symptom I experience.

[reddarin]

You work out too though don't you MC?

[zgirl]

Thanks for the input, Reddarin. You are so knowledgeable and willing to share! I supplement magnesium and potassium also - pretty aggressively on the magnesium and when I don't take it I really feel the difference. It's strange because I do fairly intensive sprint intervals on the treadmill and seem to be improving both speed and stamina in those, but I still get the dead-legs on the stairs. I thought it was just me!

[mizzcase]

Yes, I work out. The first 3 or 4 days back in the gym after I go strict LCHF are always really challenging, but I adapt pretty quickly. The dead legs, however, persist.

[reddarin]

Interesting.

Stair climbing strikes me as the sort of endurance exercise that a keto-adapted person would excel at.

[reddarin]

Maybe a higher consistent blood ketone level is the difference. Phinney said that getting into the upper range closer to 3.0 means the body is more efficient at using body fat for fuel.

[LarlaB]

Op....

No, you don't need to do blood tests.

I've been eating LCHF for quite some time and believe that I have been in ketosis for most of that time. My distinct symptoms are funny metallic taste in my mouth, unique smelling urine....and of course, hugely decreased appetite Of course, the initial 'atkins flu' but I only had that once so I cannot count that fatigue as a symptom. I've stayed under 45g carbs (total, not net)for 7 months w/ the exception of 3 ' slightly higher carb' days. I believe I've been in ketosis pretty much the whole time.

But I've never done a blood test though to confirm this, until today.

And yes, I am in ketosis- very nicely, in fact.

I am only testing (1x per week) to help me in my running endeavors- I'm trying to find the line of how many carbs I can eat and still stay nicely in a ketogenic state.

Of course this is my experience- I know everyone is different, but since I"ve always wondered this, I thought I'd share.

Good luck!

[shelley]

Originally Posted by LarlaB

Op....

No, you don't need to do blood tests.

I've been eating LCHF for quite some time and believe that I have been in ketosis for most of that time. My distinct symptoms are funny metallic taste in my mouth, unique smelling urine....and of course, hugely decreased appetite Of course, the initial 'atkins flu' but I only had that once so I cannot count that fatigue as a symptom. I've stayed under 45g carbs (total, not net)for 7 months w/ the exception of 3 ' slightly higher carb' days. I believe I've been in ketosis pretty much the whole time.

But I've never done a blood test though to confirm this, until today.

And yes, I am in ketosis- very nicely, in fact.

I am only testing (1x per week) to help me in my running endeavors- I'm trying to find the line of how many carbs I can eat and still stay nicely in a ketogenic state.

Of course this is my experience- I know everyone is different, but since I"ve always wondered this, I thought I'd share.

Good luck!

Congratulations on being nicely into ketosis. I thought I'd pop in here to give another perspective. I've been Atkins '72 for years....dropped gluten about 12 years ago and have done really well to be sugar free 99.9% of the time for many years. I too thought I didn't need to test since I had all the "symptoms" of being in ketosis with one exception. I was not losing weight OR inches. So, I bought the meter and strips and started testing and tweaking and I only was in ketosis (low range of .5 to .8 with one 1.0 or so) in the 5.5 months of testing and doing "all the right things" with all the right macros, etc. Tried changing to more fat, doing occasional fat fasts, etc. and just could not get into ketosis or stay there per the blood meter testing. But I felt like I was doing everything right and should have been solidly there!

So..who knows?

[LarlaB]

Originally Posted by shelley

Congratulations on being nicely into ketosis. I thought I'd pop in here to give another perspective. I've been Atkins '72 for years....dropped gluten about 12 years ago and have done really well to be sugar free 99.9% of the time for many years. I too thought I didn't need to test since I had all the "symptoms" of being in ketosis with one exception. I was not losing weight OR inches. So, I bought the meter and strips and started testing and tweaking and I only was in ketosis (low range of .5 to .8 with one 1.0 or so) in the 5.5 months of testing and doing "all the right things" with all the right macros, etc. Tried changing to more fat, doing occasional fat fasts, etc. and just could not get into ketosis or stay there per the blood meter testing. But I felt like I was doing everything right and should have been solidly there!

So..who knows?

We are all different, for sure and our bodies don't always run 'by the book'! But it sounds like you were in ketosis w/ .5- 1.0 readings. Am I not understanding correctly? I thought .5 reading is the start for indicating ketosis,, and that higher readings point more to the efficiency of the fat-for-fuel process.

I realize that I forgot to mention one crucial part- making the assumption of ketosis was based on symptoms AND weight loss. I was steadily losing the entire time- a total of 25lbs in 6 months. IF I hadn't been losing I would have been more likely to test. But my goal was weight loss and adaption for running.

I just wanted to encourage those starting out, in the same way I was encouraged...if your goal is weight loss, just try 100% compliance first and if you aren't losing, then look into testing.