Happy and frustrated -- blood test results two years after diagnosis

[ziggy_w]

Hello all,

I have just received the results from my blood test and had an appointment with the GP. The results -- in my opinion -- were great and I am very happy .

Fasting blood sugars -- 82 mg/dl (4.6 mmol),
Hba1c -- 5.0% (31),
Cholesterol -- 212 mg/dl (5.5 mmol)
HDL -- 61 mg/dl (1.6 mmol)
Trigs -- 97 mg/dl (1.1 mmol)
LDL -- 135 mg/dl (3.5 mmol)

Here comes the frustrating part though. They also took a urine sample and "shockingly" found ketones in my urine. (Result is four times positive -- whatever this means) So, the GP wants me to go the hospital to get checked for ketoacidosis. I tried to explain to him that high ketones -- in my case -- would be normal since (a) I've been on a LCHF or ketogenic diet for two years, (b) I fasted for at least ten hours before the blood test, and (c) did an hour on the elliptical trainer before going to bed without any food after sports.

I also pointed out that there is a difference between nutritional ketosis and ketoacidosis and that ketones without elevated blood sugars generally do not indicate ketoacidosis. All to no avail. I am just so frustrated.

To be honest -- I was ready to celebrate tonight -- more than one year without medication and a non-diabetic Hba1c, which means I am in remission. This business, however, put a bit of a damper on things.

What do you guys think? If you were in my position, what would you do?

 

[AM1874]

Hi @ziggy_w ..
First .. congrats on your results
Second .. unlike yourself, I don't know enough about ketone levels to be confident about this, so I would go to the hospital for testing .. even if it was only to put my mind at rest

 

[Bluetit1802]

Hells Bells, those are fantastic results. Your doctor needs re-training.

I don't know what 4 times positive means. Did you get a print out so you could see the actual result for yourself - would be a good idea.

Can you email or give him some links showing the difference between nutritional ketosis and ketoacidosis ? It sounds like he needs to know. Then I would refuse the hospital appointment and celebrate tonight.

 

[BrianTheElder]

Hello all,

I have just received the results from my blood test and had an appointment with the GP. The results -- in my opinion -- were great and I am very happy .

Fasting blood sugars -- 82 mg/dl (4.6 mmol),
Hba1c -- 5.0% (31),
Cholesterol -- 212 mg/dl (5.5 mmol)
HDL -- 61 mg/dl (1.6 mmol)
Trigs -- 97 mg/dl (1.1 mmol)
LDL -- 135 mg/dl (3.5 mmol)

Here comes the frustrating part though. They also took a urine sample and "shockingly" found ketones in my urine. (Result is four times positive -- whatever this means) So, the GP wants me to go the hospital to get checked for ketoacidosis. I tried to explain to him that high ketones -- in my case -- would be normal since (a) I've been on a LCHF or ketogenic diet for two years, (b) I fasted for at least ten hours before the blood test, and (c) did an hour on the elliptical trainer before going to bed without any food after sports.

I also pointed out that there is a difference between nutritional ketosis and ketoacidosis and that ketones without elevated blood sugars generally do not indicate ketoacidosis. All to no avail. I am just so frustrated.

To be honest -- I was ready to celebrate tonight -- more than one year without medication and a non-diabetic Hba1c, which means I am in remission. This business, however, put a bit of a damper on things.

What do you guys think? If you were in my position, what would you do?

Hi
I would be irked as well. I am always in ketosis and it would be a big disappointment if I didn't find ketones in my urine (however, I use blood test strips). However, I think you need to go along with the tests as it will be a learning experience for your GP and you don't want any anomalies on your medical records. Well done on your results by the way!

 

[sally and james]

There's a section here, https://www.dietdoctor.com/low-carb/ketosis#ketoacidosis on Diet Doctor which goes through the various levels of ketosis. If your "4 times positive" means 4mmol/L, that is just above "Optimal Ketosis" and entering what is called "starvation" ketosis. Sounds to me as if you were ready for your breakfast!
Brilliant results!
Sally

 

[Guzzler]

There are two reasons I would go to the hospital. The first is that because I am a newly-ish diagnosed T2 I would panic and do what the GP told me to do (have I mentioned that the term 'panic merchant' was named after me?).
The second reason I would go is that I would want to set my own mind at rest and prove to the GP that he should perhaps look again at his knowledge levels on the mechanisms of Diabetes.

Congratulations on your numbers, you have put so much effort into gaining your status that the ketone issue shouldn't deter you from celebrating your success. Well done, that lass!

 

[ziggy_w]

Hi @ziggy_w ..
First .. congrats on your results
Second .. unlike yourself, I don't know enough about ketone levels to be confident about this, so I would go to the hospital for testing .. even if it was only to put my mind at rest

Thanks for your advice, @AM1874. I am still waffling a bit about whether to go to the hospital to get it checked out. I just wished that more medical professionals were cued in to a ketogenic diet.

 

[Prem51]

Great results @ziggy_w, congratulations!
As to the ketones. I've no idea what that means. My GP has never had urine samples tested. I just get the blood test.
If it was recommended for me I would do the hospital tests. Any information and knowledge is good in my book.
But celebrate tonight!

 

[ziggy_w]

Hells Bells, those are fantastic results. Your doctor needs re-training.

I don't know what 4 times positive means. Did you get a print out so you could see the actual result for yourself - would be a good idea.

Can you email or give him some links showing the difference between nutritional ketosis and ketoacidosis ? It sounds like he needs to know. Then I would refuse the hospital appointment and celebrate tonight.

Hi @Bluetit1802,

Thanks so much for your cheers and your feedback. This is generally how I feel too -- but being told by the GP that I am on the edge of ketoacidosis, I can't help but feel a bit uncertain in spite of the tons of reading I have done on the subject.

I am not sure what he means by four times positive either -- this is what is written on the transfer to the hospital. Based on the conversation though, they seem to have used a dipstick on the urine and it seems to be the fourth level. I really never tested ketones before.

 

[Bluetit1802]

Hi @Bluetit1802,

Thanks so much for your cheers and your feedback. This is generally how I feel too -- but being told by the GP that I am on the edge of ketoacidosis, I can't help but feel a bit uncertain in spite of the tons of reading I have done on the subject.

I am not sure what he means by four times positive either -- this is what is written on the transfer to the hospital. Based on the conversation though, they seem to have used a dipstick on the urine and it seems to be the fourth level. I really never tested ketones before.

If you still feel uncertain, then go for the hospital appointment. Hopefully they will send you away along with a rude note to your GP.

 

[ziggy_w]

Hi
I would be irked as well. I am always in ketosis and it would be a big disappointment if I didn't find ketones in my urine (however, I use blood test strips). However, I think you need to go along with the tests as it will be a learning experience for your GP and you don't want any anomalies on your medical records. Well done on your results by the way!

Hi @BrianTheElder,

Thanks so much for your feedback -- this is kind of what I thought too. I have read many posts here where posters were happy when ketones were high. I guess my problem is that intellectually I realize that many health professionals don't know much about nutritional ketosis, but that in spite of this I feel worried about what my GP says.

 

[badcat]

Id want a blood test for ketones rather than a urine test

 

[Fleegle]

I would separate the two things completely. Firstly - what fantastic results.
I would rejoice and party hard on my HBA1C results, consider myself in remission and enjoy it.

I would also go to hospital for my ketone levels and make sure that nothing else is wrong and satisfy myself that they are indeed nothing to worry about. I am sure they are not because I thought you needed both high BG and Ketones to have any issues. So it will just be a rubber stamp and once that is done.... I would party hard for a second time

 

[ziggy_w]

There's a section here, https://www.dietdoctor.com/low-carb/ketosis#ketoacidosis on Diet Doctor which goes through the various levels of ketosis. If your "4 times positive" means 4mmol/L, that is just above "Optimal Ketosis" and entering what is called "starvation" ketosis. Sounds to me as if you were ready for your breakfast!
Brilliant results!
Sally

Thanks for the link, @sally and james. I have just checked out the link and it is very helpful.

 

[ziggy_w]

Id want a blood test for ketones rather than a urine test

Thanks @badcat, I agree with you. I guess that's what they'll do at the hospital.

 

[ziggy_w]

I would separate the two things completely. Firstly - what fantastic results.
I would rejoice and party hard on my HBA1C results, consider myself in remission and enjoy it.

I would also go to hospital for my ketone levels and make sure that nothing else is wrong and satisfy myself that they are indeed nothing to worry about. I am sure they are not because I thought you needed both high BG and Ketones to have any issues. So it will just be a rubber stamp and once that is done.... I would party hard for a second time

Thanks @Fleegle -- your words are very much appreciated. You're right -- I should get it checked out.

 

[AM1874]

Thanks for your advice, @AM1874. I am still waffling a bit about whether to go to the hospital to get it checked out. I just wished that more medical professionals were cued in to a ketogenic diet.

Hi @ziggy_w ..
Agreed .. but don't let your wishful thinking get in the way of finding out for yourself

 

[Goonergal]

Congratulations @ziggy_w - great results. I also get your frustration with your GP. From my understanding the ketone levels aren't anything to,worry about, but there's no harm in getting checked out.

 

[ziggy_w]

Thanks for all the advice @Goonergal, @AM1874, @Fleegle, @badcat, @sally and james, @Bluetit1802, @Prem51, @Guzzler, @BrianTheElder.

I started thinking about the urine test results this evening and started getting more and more nervous. So went to the hospital tonight to get it checked out. Results were good, no ketoacidosis -- as expected. So, I'm elated.

I also snuck a look at the letter from the hospital to my GP. Believe it or not, they recommended that I stop eating low carb. Not sure this would be a great trade -- no ketones in the urine, but diabetes, medication and possibly neuropathy, kidney problem, astherosclerosis, retinopathy and reduced life expectancy in the future .

 

[ziggy_w]

Great results @ziggy_w, congratulations!
As to the ketones. I've no idea what that means. My GP has never had urine samples tested. I just get the blood test.
If it was recommended for me I would do the hospital tests. Any information and knowledge is good in my book.
But celebrate tonight!

Hi @Prem51,

Just wanted to let you know how much I appreciate your input and your kind thoughts. After getting this checked out at the hospital tonight, it's now slightly after midnight.

Nevertheless, I am ready to celebrate right now and I will be thinking of you and all the other fabulous members of this forum and toasting to you.