Is it really necessary to test Ketones if eating low carb?

[lindijanice]

Hi All, Am now eating about 60g of carb a day - finally out of the carb flu - ugh! Is it really necessary to test for ketones? Being T2, I'm just curious, if it is that important to do so.......or can I assume that I am in ketosis with that level of carbs? Thanks/L Eating two meals a day, not experiencing any hunger, fasting 14 - 16 hours....

 

[Grateful]

AFAIK at 60g/day you can pretty much assume you are not in ketosis. I believe carb level needs to be considerably lower. But if you want to be sure, test....

Edited to add: According to the "ketosis" information collated by this website, it would be possible around 30g/day of carbs or lower. Info: http://www.diabetes.co.uk/keto/. I eat around 30g/day of carbs but tend to assume that I am not in ketosis myself, partly because I allow myself the odd "treat" every few days (and I have not tested for ketosis).

 

[chalup]

Hi, if your diet is working for you it does not matter if you are in ketosis or not.

 

[Resurgam]

Ketosis simply means using fat for fuel - and most people do it for some time every day - it is absolutely normal.
If your blood glucose is low then ketones in the blood or urine don't matter.
I checked my own carb consumption more closely recently and whilst I set my level at a maximum of 60 I am probably under 50 most days - but I am over 3 stone lighter than the maximum I recorded. I have to have ketosed that fat - it would not have gone otherwise - and it is fat, my scales measure fat content and I have a slide rule so I can see that my non fat weight has stayed the same.

 

[Grateful]

Ketosis simply means using fat for fuel - and most people do it for some time every day - it is absolutely normal.

Interesting. I am looking forward to reading this debate.

If your blood glucose is low then ketones in the blood or urine don't matter.

Hi, if your diet is working for you it does not matter if you are in ketosis or not.

Agree!

 

[lindijanice]

Thank y'all for your replies! I don't think I will worry about it until I am able to lower the carbs from 60.....My scale is telling me that something is happening positively and that is good enough for me, plus lower BSs

 

[bulkbiker]

Thank y'all for your replies! I don't think I will worry about it until I am able to lower the carbs from 60.....My scale is telling me that something is happening positively and that is good enough for me, plus lower BSs

And that's what really matters.. the BS bit really..

 

[Grateful]

Thank y'all for your replies! I don't think I will worry about it until I am able to lower the carbs from 60.....My scale is telling me that something is happening positively and that is good enough for me, plus lower BSs

I think you are absolutely right.

I am still interested in this debate though. My understanding, from reading about this nine months ago at diagnosis (when, admittedly, I was terrified and confused) went something like this:

• Moderate low-carb, very-low-carb: fairly standard options that work well to lower BG for quite a few of us. (Well, when I say "standard," they are still not routinely "prescribed" by national health structures including the NHS or in America, where I am.)
• Keto: an extreme diet, starting at something like 20g carbs/day. Theory is that the brain cannot normally function without carbs. When you enter ketosis, a strange mechanism takes over that can provide adequate energy to the brain, without originally ingesting carbs. Whether or not you are in "ketosis" can be checked (IIRC with home urine tests).
• Wild controversy about "ketosis" and whether it is safe, or sustainable in the long term.

Does this sound about right, or did I get the wrong end of the keto-stick?

There is another issue which is that there is a life-threatening condition called "Diabetic Keto-Acidosis" (DKA) which as far as I can tell, has no connection with "ketosis" as defined above. I suspect that this partially explains why health-care professionals are not terribly keen on "keto" diets.

 

[bulkbiker]

I suspect that this partially explains why health-care professionals are not terribly keen on "keto" diets.

A lot of the time due to ignorance when nutritional ketosis is confused with ketoacidosis..
Just measured my blood ketones at 1.0 so I'm nutritionally in ketosis at the moment, as I aim to be all the time anyway.
The 20g upper limit is to ensure that 99% of people can be in ketosis at the level. Some may well be in ketosis with higher levels of carb intake so @lindijanice may well be in nutritional ketosis with her 60g of carbs per day but without measuring blood ketone levels its hard to know for sure.

 

[Grateful]

Just measured my blood ketones at 1.0 so I'm nutritionally in ketosis at the moment, as I aim to be all the time anyway.

Excellent, thanks. For how long, do you think? (Not counting short lapses that don't really count.) Inquiring minds want to know!

As for me, for the first two months after diagnosis, I was not only low-carb, low-fat, I was also severely portion-controlled. I think I may very well have been in ketosis. I did not test for ketosis -- but you do, which is very useful to those of us who don't!

If you don't mind explaining, what test are you using?

With best wishes as always @bulkbiker....

 

[bulkbiker]

If you don't mind explaining, what test are you using?
@bulkbiker....

I have a meter called a Caresens Dual which measures blood glucose and ketones (although I only use it for ketones as the blood sugar test strips are expensive). I tend to measure sporadically these days as I'm an ultra low carber and keep a fairly detailed food diary so know that I should be there most of the time.

 

[Guzzler]

I am more interested in the relationship between ketones and IR. As someone who can't afford to lose any more weight (I put on 3lbs in the last two weeks. Yay!) I would be intrigued to know if anyone can steer me toward learning more about the mechanics of ketosis. TIA

 

[ringi]

• Firstly most people with high levels of insulin resistance find it hard to switch into and out of ketosis.
• A "normal" person with a reasonable diet will be in ketosis most nights, due doing at least an 8 hr fast. We are not normal people due to having insulin resistance!
• The very low carb people aim to be in ketosis all the time, this is the best option for someone with a very high level of insulin resistance who has few functioning beta cells left. (They will also have to keep doing it for life.) Most of us still have a large number of functional beta cells so are not forced to take this option. Also, its possible that beta cells will "wake up" if enough fat is removed from them.
• Intermittent Fasting (for example fasting for 16 hrs a day) will put most people with Type2 into ketosis for at a few hours a day. Without the person having to learn how to eat a very low carb diet.
• Very low calories diet (Newcastle diet, or 8-week blood sugar diet for example) will put everyone into ketosis after the first few weeks.
• Reducing carb intake and not eating/drinking any carbs between meals we put a lots people who have not had Type2 for long into ketosis for a short time between meals. This is way just getting people to think about carbs often works......

We can only burn fat while in ketosis, and we must burn the fat from your liver to get any chance of controlling BG. Proving you are in ketosis by measurement of blood etc, is harder than getting into ketosis!

Keytones meters are used as a way to provide people rapid positive feedback on their diets, just like we get people to use BG meters. (BG meters don't work well for this feedback if someone BG is controlled with insulin, as there BG will remain the same. However, they can track their reduction in insulin need.)

 

[Robbity]

I learned fairly recently that it's more impotant to be "fat adapted" than in ketosis, though you may need to be in ketosis, or at least eating a very low levels of carbs, to get there to start with. We need to be eating few enough carbs for long enough (times & levels depend on the individual) for our body to make a chemical change to enable this to happen, and we can then use both carbs/glucose and fats for fuel, but we don't actually need to be in ketosis at all for this to work. Because it's easier for our bodies to preferentially use carbs as fuel, on a high carb diet this is what happens and it would appear that we then "lose" our natural ability to also use any fats either dietary or from our stored body fats for fuel as we will tend to get enough from our carby diets.. But once we're (back being) fat adapted it's much harder to lose this ability than it is to stay in ketosis if we might eat (a few!!) more carbs occasionally. Apparently being in ketosis and being fat adapted can be mutually exclusive.

(This is my idiots understanding/guide, and there are various blog posts which will explain the process in more technical detail. I've posted links elsewhere, I'll see if i can find this post again...))

Robbity

 

[bulkbiker]

Apparently being in ketosis and being fat adapted can be mutually exclusive.

That's a new one on me...

 

[Bluetit1802]

I have no idea whether I am in ketosis or not. I have never measured ketones. I eat a low carb high fat diet, with normal protein. (more than the restrictive recommended amounts) I lost all my excess weight (over 33% of body weight) in the first 9 or 10 months and have maintained this weight for 3 years. I have never seen any reason to test. My BS levels are normal most of the time.

 

[Robbity]

That's a new one on me...

Well it was sort of for me too - though I knew I was regularly in and out of ketosis - often on a day to day basis... But:
http://www.tuitnutrition.com/2017/09/measuring-ketones.html
(one of the links I was referring to in previous post)

Robbity

 

[wiflib]

I was measuring ketones in the early days (almost 10 years ago) because it was fun and a competition between me and another famous forumite. We only had wee sticks in those days and the darker the purple the better. I'm day 13 of fasting and I bloody stink of the things.

 

[BrianTheElder]

I learned fairly recently that it's more impotant to be "fat adapted" than in ketosis, though you may need to be in ketosis, or at least eating a very low levels of carbs, to get there to start with. We need to be eating few enough carbs for long enough (times & levels depend on the individual) for our body to make a chemical change to enable this to happen, and we can then use both carbs/glucose and fats for fuel, but we don't actually need to be in ketosis at all for this to work. Because it's easier for our bodies to preferentially use carbs as fuel, on a high carb diet this is what happens and it would appear that we then "lose" our natural ability to also use any fats either dietary or from our stored body fats for fuel as we will tend to get enough from our carby diets.. But once we're (back being) fat adapted it's much harder to lose this ability than it is to stay in ketosis if we might eat (a few!!) more carbs occasionally. Apparently being in ketosis and being fat adapted can be mutually exclusive.

(This is my idiots understanding/guide, and there are various blog posts which will explain the process in more technical detail. I've posted links elsewhere, I'll see if i can find this post again...))

Robbity

Hi. My understanding is that fuel selection is made through the Randle Cycle, which decides whether you are in glycoysis (glucose burning) or lipolysis (fat burning). These are mutually exclusive. The body prefers glycolysis if glucose is in good supply because it's readily available. It takes longer to get at any fat reserves. For someone like me who trys to stay in ketosis all the time, having excess carbs takes you out of lipolysis immediately and it takes 3-4 days to get back to ketosis, during which time any faty ou eat is being stored as body fat and not burned. So I try really hard not to eat any carbs!

 

[Pinkorchid]

I was measuring ketones in the early days (almost 10 years ago) because it was fun and a competition between me and another famous forumite. We only had wee sticks in those days and the darker the purple the better. I'm day 13 of fasting and I bloody stink of the things.

Just curious why do you fast for so long and what is the advantage for you to do it I take it you do have fluids though