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Old 08-16-2013, 04:00 AM   #1
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Blood ketone testing question

To determine whether or not you are in ketosis, do you just test your morning blood ketones? Is there any point on testing throughout the day? I am just curious how to use my blood ketone meter in a way that makes sense.

Any feedback on how you use it would help me. Thanks.
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Old 08-16-2013, 06:39 AM   #2
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Morning ketones are actually typically very low. I test at night, before bed. If you are into blood ketones testing, I recommend looking through/searching Jimmy Moore's Livin' La Vida Low Carb site. He's big on that stuff! Compares meters, tracks a lot to show trends, etc. It's always possible that it's different from person to person, of course, but he has a lot of good info out there
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Old 08-16-2013, 06:56 AM   #3
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Morning ketones are actually typically very low. I test at night, before bed. If you are into blood ketones testing, I recommend looking through/searching Jimmy Moore's Livin' La Vida Low Carb site. He's big on that stuff! Compares meters, tracks a lot to show trends, etc. It's always possible that it's different from person to person, of course, but he has a lot of good info out there
found this info on a blog:

Quote:
One of the speakers at the Nutrition and Metabolism Society meeting in 2011 was Dr. Adam Hartman, who is an expert in the use of ketogenic for the control of epilepsy in children. He made an interesting comment on the timing of testing for ketones. When eating the typical mixture of foods that people normally consume in our society (a mix of proteins, carbohydrates and fats), ketones are highest in the morning. This makes sense because the least flow of carbohydrates in from the digestive tract is overnight, so the body burns some fat in the night. When eating a ketogenic diet, on the other hand, the most exposure to carbohydrates is overnight especially towards morning as the liver produces glucose to keep your brain fueled and to prepare you for getting up. Therefore, if you are eating a very ketogenic diet, the blood ketones go up during the day as you burn more fat for fuel.
Also, MCT oil or coconut oil can make the levels go up, so I don't test after I've had CO earlier.
I test in the mornings, fasting usually because I figure that's the lowest it will be.
I also can tell you that if you didn't get a good night's sleep, the reading may be wiggy--- has to do with cortisol levels impacting insulin which impacts glucose which impacts ketones.

Last edited by emel; 08-16-2013 at 06:57 AM..
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Old 08-16-2013, 07:42 AM   #4
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I agree that blood should be checked in the morning before eating. If it is in the zone then, and you are eating right during the day, you know it will only go up as long as you are eating right. And eating coconut oil and MCT oil will raise them, too.

So there is really no point in checking them later in the day. And the strips are expensive!
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Old 08-16-2013, 08:03 AM   #5
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I agree that blood should be checked in the morning before eating. If it is in the zone then, and you are eating right during the day, you know it will only go up as long as you are eating right. And eating coconut oil and MCT oil will raise them, too.

So there is really no point in checking them later in the day. And the strips are expensive!
Rebecca, what is your thinking about the CO/MCT in regards to ketone testing? Do you think it artificially raises the blood ketone level reading, or do you think it shows a bona fide increase of fat-burning?
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Old 08-16-2013, 09:31 AM   #6
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Rebecca, what is your thinking about the CO/MCT in regards to ketone testing? Do you think it artificially raises the blood ketone level reading, or do you think it shows a bona fide increase of fat-burning?
I think it does just what it ways it does - it reads how many ketone bodies are in the blood at the time of the test. CO/MCT increases ketone bodies in the blood, which will show up on the test.

Now, whether or not we should care about that, I'm not sure. Does it matter to fat burning if the ketones are produced more by our bodies or by the CO/MCT? I don't now the answer to that.

But I do know that if I have not ingested any CO/MCT for the past several hours, and my blood test comes out over 1.0, I am happy.

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Old 08-16-2013, 09:56 AM   #7
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I also test in the morning, fasting. I figure since that's my lowest reading, if that's over 0.5, I'll be golden the rest of the day.
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Old 08-16-2013, 10:07 AM   #8
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I also test in the morning, fasting. I figure since that's my lowest reading, if that's over 0.5, I'll be golden the rest of the day.
Exactly!
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Old 08-16-2013, 10:17 AM   #9
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Agree. And I agree about the MCT--- I don't think it has a special property which causes us to burn body fat. I think it puts out ketones as it digests and has nothing to do with body fat burning. I think purposely raising your ketone readings by taking MCT is not a solution, because what we're after is burning body fat and not taking in too many carbs. OTOH, if eating MCT helps keep people away from excess carbs, it is a good thing.
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Old 08-16-2013, 11:20 AM   #10
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There is one exception. And I am that exception. I only store body fat in one place on my body and unfortunately it is in an area that doesn't very often release fat into my blood stream for energy. The fat will be stored there, but it never seems to be released. How do I know this? Because I can consume a 1500cal meal, and an hour later still be hungry. And this happens on a HC AND a LC diet. I do supplement my diet a lot with MCT oil because it keeps me from overeating. But it only works when I am in ketosis. When I was on a higher carb eating, it was the same thing except bingeing on sugary foods. Even though I was technically considered over weight. I was always hungry.

Although I am perplexed by the testing. In the mornings my readings are often really low 0.3mmol. I feel like I am in ketosis, but maybe I am still eating too many carb/protein.
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Old 08-16-2013, 01:36 PM   #11
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There is a misconception that being in ketosis means that you will lose weight. Being in ketosis only means that your main fuel source is fat instead of sugar. If you are taking in too much fuel, or if your fat stores will not "open up", you can be in ketosis and not lose body fat.

Would you like to share in detail what you are eating and we can help you trouble shoot?
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Old 08-16-2013, 05:13 PM   #12
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Ok thanks.

B: 1 Tbsn MCT oil, 1 Tbsn carob powder, 1/4 c. low fat cream cheese, 1/2 Tbsn pecan butter with 1/2 Tbsn MCT oil.

L: Coffee with half and half cream (2T)
100g tofu with 1 Tbsn MCT oil and 1/2 artichoke

D: 300g bok choy, 1 Tbsn MCT oil, 1 Tbsn egg replacer, 1 Tbsn cream
1/2 avocado, 1 oz romano cheese, 1/2 roma tomato.

Plus I have had about 1/4 of 18% cream in coffee and tea through out the day.

Does that help at all?
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Old 08-16-2013, 05:59 PM   #13
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That's a good start! Can you also tell us how many grams of fat, protein and carbs are in the above menu?

Also, are you a vegetarian?
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Old 08-16-2013, 08:28 PM   #14
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Maybe about 20g carbs, 90g fat, 45 protein. I am not a vegetarian but I have a lot of difficulty staying in NK when I eat meat. Some meats are too lean and therefore the fat/protein ratios of my meals tend to be too low. When I do eat meat it is usually things like ground beef, sausages, salmon etc. The leaner ones I tend to use more as garnishes. I even have difficulty with things like eggs for breakfast so I try to avoid doing that.
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Old 08-17-2013, 03:10 AM   #15
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Only 45g of protein is too low, unless you are under 5 feet tall. Is there a reason you are eating so little protein? How tall are you?

Ratios of fat to protein do not matter - your body does not "read" food that way. All that matters is the absolute amounts of the different macros that your body needs. The first thing you need to do is figure out the right amount of protein to eat. Would you be open to letting me help you figure that out? I have a calculator that I use that uses height as a starting point.
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Old 08-17-2013, 03:34 AM   #16
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I am 5'3 and weight somewhere between 95 and 100lbs. My recommended intake is around 60g, I find I have to keep my carbs and protein low in order to stay in ketosis. I find anything much more than 50g protein will drop my blood ketones below 0.5mmol. I seem to have to have a lot of fat in my diet to remain in NK.
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Old 08-17-2013, 05:22 AM   #17
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If you are 5'3" and you only weigh 95-100 pounds, why are you trying to stay in NK? Are you trying to lose weight or maintain?

Also, I found that I was able to eat more protein when I stopped eating vegetables all together. I am zero carb now, and I was able to increase my protein substantially.
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Old 08-17-2013, 09:53 AM   #18
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Originally Posted by LC_pickle View Post
Morning ketones are actually typically very low. I test at night, before bed. If you are into blood ketones testing, I recommend looking through/searching Jimmy Moore's Livin' La Vida Low Carb site. He's big on that stuff! Compares meters, tracks a lot to show trends, etc. It's always possible that it's different from person to person, of course, but he has a lot of good info out there
How does one test for blood ketones? I am only familiar with peeing on the ketostix!
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Old 08-17-2013, 10:04 AM   #19
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How does one test for blood ketones? I am only familiar with peeing on the ketostix!
There's a couple of glucose meters that also test for ketones if you buy the pricy ketone strips for it. Use a lancet to prick your finger and put a drop of blood onto the strip and the meter will get the reading in a few seconds.

You can also use the same meter to test for glucose. Those strips are much less expensive.

There's currently a recall on the NovaMax meter (but the recall pertains to the glucose readings). The other brand I'm aware of is Precision Xtra. The meter kits are inexpensive. The ketone strips are not. My Novamax kit came with a bunch of glucose strips, a few ketone strips, test solution, lancet, and several needles.
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Old 08-17-2013, 10:08 AM   #20
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There's a couple of glucose meters that also test for ketones if you buy the pricy ketone strips for it. Use a lancet to prick your finger and put a drop of blood onto the strip and the meter will get the reading in a few seconds.

You can also use the same meter to test for glucose. Those strips are much less expensive.

There's currently a recall on the NovaMax meter (but the recall pertains to the glucose readings). The other brand I'm aware of is Precision Xtra. The meter kits are inexpensive. The ketone strips are not. My Novamax kit came with a bunch of glucose strips, a few ketone strips, test solution, lancet, and several needles.
I already have a glucose meter and test strips [yeah, the test strips are insanely expensive!] but I would guess it only measures glucose, right? Is it worth the price and effort to test blood ketones or do you think just peeing on the ketostix is good enough?

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Old 08-17-2013, 11:55 AM   #21
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I already have a glucose meter and test strips [yeah, the test strips are insanely expensive!] but I would guess it only measures glucose, right? Is it worth the price and effort to test blood ketones or do you think just peeing on the ketostix is good enough?

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Thanks lol.

Like I say, I know of 2 glucose meters which also test for ketones. Those are the Novamax and the Precision Xtra. so if yours isn't one of those, it won't do it.

Is testing for ketones necessary? Not at all.
For me, it is a handy way to see what foods do to me. I'm doing an Atkins OWL type program, so first I found my baseline of blood ketones by doing a week of testing. Now when I add foods back in, I eat them for a few days and test again.

Another thing I did is to test after my lousiest day. I don't eat off-plan foods, but sometimes my meal timing is iffy. And I drink bourbon in limited quantities (it's on Atkins DANDR lol... look it up! And this isn't a race for me--- I'm crafting a plan I can live with forever.) When I tested after a day of pushing my limits with booze, meal timing, and dining out I was still firmly in ketosis, so I guess my worst behavior is okay occasionally.

This was all done after being firmly on Induction-style plan for several weeks. Nice to know what I can get away with, but I'm sure it slows my losses.


Anyway, about the pee stix, I don't think they're very accurate, and they monitor the ketones that spill out into your urine, not what you're burning. And they only measure one of the 3 types of ketones the body produces. And after you've been in ketosis for awhile, you have more of one of the kinds the ketostix don't test for, so you're not getting to 'count' those more prevalent ones in your reading. And then there's the impact of water-drinking.... your urine ketone readings will vary depending on how hydrated you are.

So bottom line.... IMO ketostix are fine for determining if you are in ketosis at the beginning of a low carb eating plan, but they're not useful after we're there.
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Old 08-17-2013, 12:28 PM   #22
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Thanks lol.

Like I say, I know of 2 glucose meters which also test for ketones. Those are the Novamax and the Precision Xtra. so if yours isn't one of those, it won't do it.

Is testing for ketones necessary? Not at all.
For me, it is a handy way to see what foods do to me. I'm doing an Atkins OWL type program, so first I found my baseline of blood ketones by doing a week of testing. Now when I add foods back in, I eat them for a few days and test again.

Another thing I did is to test after my lousiest day. I don't eat off-plan foods, but sometimes my meal timing is iffy. And I drink bourbon in limited quantities (it's on Atkins DANDR lol... look it up! And this isn't a race for me--- I'm crafting a plan I can live with forever.) When I tested after a day of pushing my limits with booze, meal timing, and dining out I was still firmly in ketosis, so I guess my worst behavior is okay occasionally.

This was all done after being firmly on Induction-style plan for several weeks. Nice to know what I can get away with, but I'm sure it slows my losses.


Anyway, about the pee stix, I don't think they're very accurate, and they monitor the ketones that spill out into your urine, not what you're burning. And they only measure one of the 3 types of ketones the body produces. And after you've been in ketosis for awhile, you have more of one of the kinds the ketostix don't test for, so you're not getting to 'count' those more prevalent ones in your reading. And then there's the impact of water-drinking.... your urine ketone readings will vary depending on how hydrated you are.

So bottom line.... IMO ketostix are fine for determining if you are in ketosis at the beginning of a low carb eating plan, but they're not useful after we're there.
Thanks for that info. I agree with your viewpoint about doing something you can LIVE WITH not just a quick fix. I doubt I could afford those meters so I guess I'll have to just use my ketostix for now!
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Old 08-17-2013, 02:56 PM   #23
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If you are 5'3" and you only weigh 95-100 pounds, why are you trying to stay in NK? Are you trying to lose weight or maintain?

Also, I found that I was able to eat more protein when I stopped eating vegetables all together. I am zero carb now, and I was able to increase my protein substantially.
I am trying to maintain. Actually gain a bit but mostly maintain. I don't eat vegetables. Sometimes I eat bok choy and once in awhile some lettuce and a bit of tomato. I usually only eat lettuce when I am out and the menu for LC is limited. 0 Carb? How is that possible? What are you eating?
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Old 08-17-2013, 04:34 PM   #24
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I am trying to maintain. Actually gain a bit but mostly maintain. I don't eat vegetables. Sometimes I eat bok choy and once in awhile some lettuce and a bit of tomato. I usually only eat lettuce when I am out and the menu for LC is limited. 0 Carb? How is that possible? What are you eating?
The term "zero carb" is a general term that differentiates an all-animal diet with a diet that includes plants. Since there are some carbs even in animal sources, like cheese, organ meats, eggs and shellfish, it is not technically zero carbs. It is extremely low carb, with the only carbs coming from animal sources.

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Old 08-17-2013, 04:37 PM   #25
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I am trying to maintain. Actually gain a bit but mostly maintain.
If you are trying to maintain or even gain a little bit, why are you trying so hard to stay in nutritional ketosis?
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Old 08-18-2013, 03:41 AM   #26
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If you are trying to maintain or even gain a little bit, why are you trying so hard to stay in nutritional ketosis?
I'm not doing NK to lose weight. I'm doing it because I have a history of yoyo dieting and because my dad was a type 2 diabetic. Although my body still produces insulin, I don't tolerate carbs very well. I count calories and if I eat too many carbs I over-eat, binge and have food fantasies. I have gotten up in the middle of the night and done things like eat a loaf of bread. Doing LC is the only thing that has helped me. I have successfully lost weight on a High to moderate carb diet, but never been able to maintain the weight. As soon as I went off the diet I was back to the food behaviours that got me back to square one. NK keeps me functioning on fat so I don't have to reintroduce carbs which causes the problems I listed above.

Anyways, I have tried the diet you are talking about. Twice actually. The first time I was able to stay on the animal based diet for about a week, then I found myself bingeing out of control on carby foods shortly after starting the diet. The second time I tried it was recently on the advice of a person trainer who wanted me to up my protein from about 55g/day to roughly 100g a day. It knocked me out of ketosis and I had a week long binge of eating "barely legal" foods and feeling really moody and unwell until I was able to get back in. So from experience I can say that I have to be more careful than the average person on here. I think it is because I need a lot more fat in my diet. If you over-eat protein your body will turn the excess into glucose which will definitely keep you out of NK. The body only remains in ketosis if it is living on mostly fat. Some people can ingest little fat and remain in ketosis and my husband is an example of someone like that. He can go hours without eating and I don't understand how he does it. But he is also obese. I can tell his body is efficient at extracting fat from his fat stores, he exhibits all the physical signs of ketosis. He also never binges on anything. Not me. I eat a bite of something sweet and I will clean out the entire refrigerator when I am not in NK.
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Old 08-18-2013, 05:06 AM   #27
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Thanks for that explanation! It sounds like you are trying to do what is best for your body and your emotional state.

If you keep your protein around 55-60, and do not go lower, I can't see where it would be a problem. I just saw that you had posted that you only ate 45g of protein. I would suggest that you make sure you do not dip that low.
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Old 08-18-2013, 06:01 AM   #28
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These situations are where I'm amazed at how different everyone's body is and that how we process foods, our metabolism, everything, etc. is just something we have to discover for ourselves. There is no one-size-fits-all in the diet world. More and more I'm realizing this is all about health, but it's easier to say that as I get closer to goal. Truthfully, there's an awful lot of vanity involved.
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