Criteria For Keto-Adaptation Success

[johnb46]

I have seen on one of Stephen Phinney's YouTube videos and/or the Virta Blog Keto-adaptation entry, that there is a difference between being in ketosis and being keto-adapted, the latter taking 3 months in some people. (I know it can take much longer to recover your full fitness levels, even once you are keto-adapted).
I am definitely in ketosis, as measured by urine test strips over 14 weeks and, (just to be sure) over the last 3 weeks by occasional measurements using an eBketone meter. Range of meter measurements taken at various times on different days: 0.6 to 3.3. Range of 3 measurements taken one after the other to check meter consistency: 1.9 - 2.2. So solidly in ketosis.

My HbA1c after 14 weeks is 42, which is down a few points.
So that's good, but:
a) The most important question: What are the quantifiable criteria that allow me to check whether I am keto-adapted?

b) Does / should being keto-adapted, as opposed simply to being in ketosis for 14 weeks, make a difference to the HbA1c level I can be expected to achieve?

c) Does HbA1c continue to improve over a longer period of time; for instance, if you measure it 3 months after being definitely keto-adapted, can you expect it to get much better over the following year?

Many thanks,
John

 

[bulkbiker]

What are the quantifiable criteria that allow me to check whether I am keto-adapted?

The main one seems to be the ability to not eat for 24 hours and not really feel hungry. if you get pangs drinksome water leave it for 30 minutes and see if you still feel the pangs.

Does / should being keto-adapted, as opposed simply to being in ketosis for 14 weeks, make a difference to the HbA1c level I can be expected to achieve?

I doubt it will have a significant effect but your blood sugar levels should have been so much better that your HbA1c should drop like a stone.

Does HbA1c continue to improve over a longer period of time; for instance, if you measure it 3 months after being definitely keto-adapted, can you expect it to get much better over the following year?

Depends on the level you get down to.. obviously it can't go down forever or you'd die.
Mines been around 27 mmol/m since July 2016 pretty consistently.

 

[johnb46]

The main one seems to be the ability to not eat for 24 hours and not really feel hungry. if you get pangs drinksome water leave it for 30 minutes and see if you still feel the pangs.

I doubt it will have a significant effect but your blood sugar levels should have been so much better that your HbA1c should drop like a stone.

Depends on the level you get down to.. obviously it can't go down forever or you'd die.
Mines been around 27 mmol/m since July 2016 pretty consistently.

Thanks, Bulkbiker.
Hmm! Fast for 24 hours w/o feeling hungry. Clearly, I hadn't appreciated the challenges involved.

 

[Brunneria]

I'm definitely keto-adapted, and have been for years, but I can't fast for 24 hrs without wanting to gnaw the arm off the nearest child. So I don't think that lack-of-hunger is a universal experience. I have never seen the wondrous benefits of hunger-free fasting that others experience.

As for HbA1c dropping... nope. My bg didn't plummet anywhere (moresthepity). Although I am now firmly below of T2 bg levels.

My responses to your questions are (in my opinion)
(You certainly won't find me quoting hard lines, numbers, or anything, since those are just things people like to use to score points off each other about.)

a) What are the quantifiable criteria that allow me to check whether I am keto-adapted?
Feeling better. Having more energy. Having more stamina. Having much better resistance to the cold. Losing the dragging weighed down feeling caused by irregular bgs and insulin resistance.
Oh, and the capacity to eat a few carbs here and there as occasional indulgences then slip easily and comfortably back and forth, in and out of hardcore keto, without experiencing energy loss or 'keto flu'. As Steven Phinney regularly says, the depth of keto is irrelevant to either bg control or weight loss, and as Amy Berger points out, the phrase 'getting kicked out of ketosis' is both inaccurate and misleading. It isn't a switch, it is more like a dial, and once we are past the first few days of 'going keto' our bodies show remarkable adaptability.

b) Does / should being keto-adapted, as opposed simply to being in ketosis for 14 weeks, make a difference to the HbA1c level I can be expected to achieve?
Blood glucose levels are only relevant to keto in that if they are too high, then you have too much bg and insulin floating about to be properly in ketosis. Keto really shouldn't be some kind of competition to get numbers lower than other ppl's.

c) Does HbA1c continue to improve over a longer period of time; for instance, if you measure it 3 months after being definitely keto-adapted, can you expect it to get much better over the following year?
Not necessarily. Depends on what you are eating and where your body likes to stabilise its bgs at. We are not all the same. Some of us have other health issues that affect our endocrine system, activity levels, appetite, etc. which also affect how our bodies handle both ketosis and ketoadaptation.

Bottom line: If you are feeling better, are eating consistently well, are getting excellent nutrition, and your bgs are within a good range, then don't worry about the fine line between keto and keto-adaptation.

 

[johnb46]

I'm definitely keto-adapted, and have been for years, but I can't fast for 24 hrs without wanting to gnaw the arm off the nearest child. So I don't think that lack-of-hunger is a universal experience. I have never seen the wondrous benefits of hunger-free fasting that others experience.

As for HbA1c dropping... nope. My bg didn't plummet anywhere (moresthepity). Although I am now firmly below of T2 bg levels.

Bottom line: If you are feeling better, are eating consistently well, are getting excellent nutrition, and your bgs are within a good range, then don't worry about the fine line between keto and keto-adaptation.

Dear Brunneria, thank you for your advice/opinions and taking the trouble to answer all those questions.