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

Goonergal said:
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.
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Hi @Goonergal,

Thank you also so much for your kind thoughts and your input.

I know you'll get your results on Friday -- so I'm keeping my fingers crossed. I'm absolutely confident your results will be great.
 
Congrats on your results.
In my personal experience, you have nothing to worry about! (Famous last words!!)

Well done !
 
Very well done. Better than excellent.
 
Congratulations on all your hard work.

Get the test to make your Dr happy, then forget about it.

It took me a year and an un-required angiogram to convince my cardiologist the chest pains were due to the tablets he was prescribing me....
 
Hi @ziggy_w ..
Great news .. I'm really pleased that you have got this ketone thing settled. Sad, though, that these idiot Docs want you to stop the very thing that has brought you out of the depths. Where do they find these clowns?
 
Thanks so much for kind words and advice, @Lamont D, @MartinK9, @Contralto @Mbaker and all of the others that gave such considered and helpful advice.

Another update after a night of research. I googled the numbers reported in the doctor's note from the hospital to my GP and found out that the information given to me by the hospital doctor wasn't quite correct and there is a problem after all. In fact, my blood is acidic and there is a bicarbonate deficiency. However, oxygen saturation of the blood, oxygen particle pressure and carbondioxide particle pressure were normal.

I sincerely hope that none of these results was a huge problem -- as the hospital released me to go home after looking at the results.

Reasons for the low bicarbonate levels (which impact blood acidity) might be a problem with the kidneys -- so I'll schedule a kidney test. The hospital doctor also recommended that a kidney test should be scheduled in the next couple of weeks.

Another reason, however, might be a ketogenic diet and/or starvation diet. This is, at least to some extent, applicable in my case.

Trying to lower my average and fasting blood sugar levels, I've done about an hour high intensity exercise on the elliptical trainer almost every single day for the last month burning about 800 cals per day. Plus, I've not eaten very much during this time, especially not enough protein. In addition, I've also had a problem drinking enough ever since my blood sugar levels normalized.

So, I'm thinking it might be good idea to modify my diet a bit and substitute some of the fat with some more protein, and cut back on the exercise a bit. An additional benefit of more protein might also be that it will up insulin production, which in turn will inhibit ketone production. A third tweak, I am considering is to supplement with a bit of baking soda to up my bicarbonate levels as bicarbonate will neutralize some of the acidity. Also, I will up my water intake.

I will also buy some ketostix to see if these changes will have an impact. Wish me luck, my friends.
 

Might be worth trying one thing at a time so you know what is impacting on what.
 

Did they include dandruff?
Edit: oops! Thought that was what they were saying you would get on LCHF.

Hold the line!
You are doing great.
 
Goonergal said:
Might be worth trying one thing at a time so you know what is impacting on what.
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Hi @Goonergal,

You are right -- changing everything at once, doesn't really help to find out what is what. The problem is that other than ketostix (got them yesterday), I don't have many diagnostics to see if things change.

Here is an update. Yesterday, I didn't exercise, had four glasses of water with baking soda, and a barbecued steak (plus half an avocado as well as roasted eggplant and bellpeppers) for dinner. This morning, I did a fasting blood sugar test and a ketostix test. Results: Fbg 99 (5.5) and ketones were between weak and medium.

So, at least one of the changes I made appear to work, but it means that I am trading higher fasting blood sugars, no exercise, more protein for lower ketones. I am still not convinced that these changes in diet and lifestyle are really positive and were I want to go long term, but at least my mind is a bit more at rest.

Thanks for advice and your concern.
 
LittleGreyCat said:
Did they include dandruff?
Edit: oops! Thought that was what they were saying you would get on LCHF.

Hold the line!
You are doing great.
Click to expand...

Hi @LittleGreyCat,

Thanks for your post and for caring.

I felt very similarly to you when I red the doctor's recommendation. He actually wrote that I should switch to a more balanced diet. I would think that a ketogenic diet is actually pretty balanced -- lots of above ground vegetables and salad, eggs, cheese, fish, chicken, meat (but not too much protein), and healthy fats (such as olive oil and butter in my case).

The problem probably is that most people not familiar with this style of eating probably think of a ketogenic diet as a protein-heavy diet with hardly any vegetables. Maybe, we should be calling it a mediterranean diet without noodles, bread, rice, cereals, potatoes and tropical fruits -- then health professionals would probably be excited about this diet. It would seem that after putting diabetes into remission, we would deserve a bit more credit than this.
 


I was going to say - this happened to me - I had an accident and as part of that they measured my ketones It was at 3.9. I got a lecture about ketoacidosis, including changing my iet.

I told them they didn't know what they were talking about . I ended up giving a lecture to about 15 A&E staff about what happens when diabetics go no a low carb diet, One of them was taking notes because she wanted to try to for her father.

If the possibility of ketoacidosis truly bothers you, then the easiest way of getting rid of the panic is to read your own blood ketones now and again.

I have one of these

https://www.amazon.co.uk/Call-GK-Du...-6&keywords=on+call+blood+glucose+test+strips

https://www.amazon.co.uk/Blood-Keto...coding=UTF8&psc=1&refRID=H0N5YXEYGWF4THDRCAGC


that will soon tell you if your blood ketones start to rise anywhere dangerous £ 50 in total including 25 tests.

There should be no need to test more once in a while so 25 lasts for ages
 

For ketone testing, see:

http://www.diabetes.co.uk/forum/threads/best-ketosis-meter.120911/#post-1527752

The Caresens Duo was free with a couple of ketone strips and another pack of test strips was £9.95 so for this small sum you can check your ketones in your blood (much more accurate than a urine sample) if you are in any doubt. Having this may reassure your GP as well.

I've only tested a couple of times so far just to confirm the level of ketosis. Blood level seems slightly lower than urine level shown by Ketostix. Again I've only tested a few times just to confirm that my body is chucking out ketones.

Checking back on the leaflet which comes with the Ketostix I see that my test results so far have been in the 1.5-4 mmol/L range and tending more to the 4 mmol/L so this may equate to your "4 times positive" in your test. This is shown as "Moyen (Medium?)" on the colour chart on the bottle. The leaflet says "If the test shows a moderate or large amount of ketones , call your doctor or diabetes educator" which presumably is why your health team was showing concern.

As others have said, elevated ketones in a T1/T2 on insulin (but not on LCHF) are a sign that you need to check that you are not going into ketoacidosis. For those on a ketogenic diet the normal reaction is .

Edit: just to add that I don't think my surgery tests for ketones in blood or urine, although I may not have been in ketosis for my last urine test as they only do one a year. We shall see what happens at my next test in the next month or so.
 
@ziggy_w You have done really, really well and I'm sure you will carry on doing brilliantly with just a minor tweak or two to remedy the high ketones. Congratulations!
 
If you are going to test and track ketones I would strongly suggest getting a blood ketone meter. Ketostix are notoriously inaccurate. You need to know your blood level, not what you are peeing out.
 
Thanks so much for the advice and the links to the ketone meters, @CherryAA. I also appreciate the great advice from @LittleGreyCat and @chalup on this. I definitely will invest in a ketone meter.

To be honest, though, I wasn't really worried about ketoacidosis as my blood sugars are always quite low (99% of the time, they are below 115 mg/dl (6.4 mmol), even half an hour or an hours after eating.

Although I wasn't concerned, my GP was very worried and send me to the hospital to get it checked out, which in turn made me anxious too. Especially, since they told me at the hospital, they would keep there at least overnight, just based on the result of the ketostix. Luckily, after examing the blood acidity and oxygen saturation, they let me go home. I admit the whole thing was a bit of a nightmare for me.

Until now, I had never measured ketones because -- honestly -- I couldn't be bothered to care as long as the diet was working for diabetes.

Today, I took the hospital lab results to my GP and met with him again. He looked at the results and said that they showed my blood was slightly acidic (probably due to a month of extensive exercise and not enough protein), but he wasn't worried any longer. I also told him that after a bit more protein and less exercise yesterday, ketones had come down and were between weak to medium this morning. Furthermore, I told him that I would always have some ketones as I was eating a ketogenic diet and that my body was primarily burning fat and not sugar. He also said that he wasn't worried about my kidneys any longer. So all good.

For the first time, however, I got him slightly interested in my diet. So, I might be able to mark this as a small victory. I mentioned Virta Health, who as most of you will know, is on a mission to cure 100 million diabetics by putting them on a low carb diet (Jeff Volek, Stephen Phinney and Sara Hallberg are on board). He actually jotted down the name. Probably for the next appointment, I might bring a list with a few more resources -- who knows maybe he will spread the message (though probably this is only wishful thinking).
 
Chook said:
@ziggy_w You have done really, really well and I'm sure you will carry on doing brilliantly with just a minor tweak or two to remedy the high ketones. Congratulations!
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Thanks so much, @Chook, for your kind words. I was also very very happy with the results -- especially the HDL and trigs, as this was the first time these were tested (other than upon diagnosis). Hba1c wasn't that much of a surprise as I regularly test as do most of us.

After meeting with the GP today, I am now a bit calmer and can actually enjoy the good results. Too bad, they initially did put a bit of a damper on this.
 

You're welcome. I don't know enough about any of this to know whether slightly higher blood glucose levels (your fasting number is still very good) are a good trade for lower ketones. Guess you can only be guided by how you feel.
 
Goonergal said:
You're welcome. I don't know enough about any of this to know whether slightly higher blood glucose levels (your fasting number is still very good) are a good trade for lower ketones. Guess you can only be guided by how you feel.
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Thanks, @Goonergal.

Actually, I was feeling really good before. If the GP hadn't done a ketone test and sent me to the hospital, I would have never known that my bloods are slightly acidic. After doing tons of research from Monday night to Tuesday, I found that acidic blood levels are associated with lower bone density (as the body harvests some calcium from the bones trying to neutralize the acidity) and lower muscle mass. So, probably not a good idea in the long term.

I am a bit unhappy with accepting higher blood sugar levels, however. Like many of us on this forum, I like trying to keep my blood sugar levels in the normal non-diabetic range. This morning, fasting levels were 99 mg/dl (5.5 mmol) and if they had been just a tad higher, they would have qualified as prediabetic (in Germany prediabetes is associated with fasting levels above 100 mg/dl (5.6 mmol).

I've read somewhere on the internet (can't recall the source, though) that truly non-diabetic fasting levels are somewhere from 4.5 to 5.0. To be honest, I can only achieve these kinds of levels if I exercise extensively at night and not have much protein with dinner. If I am lazy or eat a large meal for dinner, fasting levels creep up.

There were some posts on twitter (Ted Naiman, Tim Noakes) a few days ago that many people following a low-carb or ketogenic diet have higher fasting levels (somewhere from 5.1. through 6.0 mmol). So, I probably shouldn't worry if fasting levels are a bit higher.

However, if it were only up to me and I hadn't known about the acidic blood levels, I probably would feel better continuing as before (at least when I find the time to exercise).
 
I personally wouldn't worry about the FBG levels provided your pre and post meal readings are still good.

I think it is something to do with very low carb dieters experiencing a small (and insignificant) liver dump because there is very little glucose in your body, and if that isn't sufficient to stop you going too low the liver kicks in to redress the balance. Once the glucose levels reach a "safe" level the liver stops the production of glucose and all is well again. That "safe" level will vary from person to person. I am more than willing to be corrected on this.
 

Hi @Bluetit1802,

You are right -- having higher fasting blood sugar levels shouldn't be too much of a problem. Btw, another explanation for higher fasting levels on a ketogenic diet is that the muscles become insulin resistant to spare the glucose for essential processes, which absolutely require glucose (brain and production of red blood cells if I remember correctly).

What worries me a bit, though, is that when my fasting levels are higher, my glucose levels are higher all day. So, today after having only about 10 really small strawberries with cream, I saw absolute blood sugars that were higher than any reading in the previous three months, even though the absolute rise was not higher than usual. Honestly, this scares me a bit.

In the pursuit of lower ketone levels, I had a lot of protein for dinner tonight. I actually had to physically force myself to eat so much protein -- and it really wasn't enjoyable. I did measure my ketone levels a couple of hours after dinner and they decreased considerably to something between trace amounts and weak ketone levels. At a minimum, this puts my mind at rest that my ketone levels are only high after fasting or doing strenuous exercise (i.e., when my body is not producing insulin).

However, I still wonder why my urine ketones are this high after almost two years on ketogenic diet -- since many low carbers seem to observe that ketones in urine virtually disappear after keto-adaptation.
 
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