Ketones of over 1.00

I believe the levels you are talking about fall within the nutritional ketosis range. See here about 1.5 minutes in.

EllieM said:

I believe they do too but I thought you were supposed to get used to ketones if you were in nutritional ketosis? I feel sick if my ketones go up to 1 but I'm not normally in ketosis.

@Nannymet, have you experimented with fasting, reducing and increasing carbs to see if it makes any difference? Is your weight steady? Have you ever had diabetic ketoacidosis?

My understanding (disclaimer I am not a doctor) is that up to 0.6 are totally normal, and T1s only have to consider DKA possibilities if they are over 1.5?

And one more thought, are you on metformin by any chance? Or any other drugs which have acidosis listed as a potential side effect?

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If I am ill and have high BG I often get ketones, usually by 0.6 I can’t stop being sick, over 1 and I have many more symptoms and have to call 111 or 999 depending. They do effect people differently and you often have to take into account the symptoms.

Nannynet said:

Hi its me again I'm still not doing great, problems after covid back in December, but ketones still a concern, I can get ketones of over 1.00 around 4 hours after eating , I always have around 40 to 50 carbs each meal x 3 times aday, blood sugar pretty stable I don't get ketones if levels go up, so what I'm saying if I didn't eat regularly it would be worse, I'm still worried about it, endo says don't keep testing but they make me feel unwell and nauseous when I get them, and I have to force myself to eat sometimes but I do eat regularly, I'm type 1 on novorapid and levemir, I don't know what to make f it, if anyone can through new light on this I would be really grateful as I find it scary thanks in advance to you all out there

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Have you tried eating 3 smaller meals and adding a small snack in between each meal to try and avoid nutritional ketosis? If you ate something at least every 2.5 hours would that help? I have been given this advice after having symptoms of DKA to try and get back on track.

Nannynet said:

Hi its me again I'm still not doing great, problems after covid back in December, but ketones still a concern, I can get ketones of over 1.00 around 4 hours after eating , I always have around 40 to 50 carbs each meal x 3 times aday, blood sugar pretty stable I don't get ketones if levels go up, so what I'm saying if I didn't eat regularly it would be worse, I'm still worried about it, endo says don't keep testing but they make me feel unwell and nauseous when I get them, and I have to force myself to eat sometimes but I do eat regularly, I'm type 1 on novorapid and levemir, I don't know what to make f it, if anyone can through new light on this I would be really grateful as I find it scary thanks in advance to you all out there

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What makes you certain it's the ketones that are making you feel unwell and nauseous? It could be a realm of other things such as hormones, low hydration levels, anxiety, acid reflux, supplements, etc, etc. If you're new to a keto diet (not that your diet sounds particularly low carb but it could be a lot lower than you used to eat) it could also be the keto flu: https://www.health.harvard.edu/blog/what-is-keto-flu-2018101815052

I run in nutritional ketosis with my ketones between 2 to 3 mmol/l when fasting and feel super clear-headed and energised. I have enough background insulin onboard and my blood sugars are in the normal range. I only eat 30 grams of carbs a day.

DKA is when ketones spiral to 25 mmol/l plus you're blood sugars have been consistently high over 13 mmol/l for an extended period of time and you are seriously unwell and you don't have enough insulin on board. If you are unwell follow sick days rules. If you think you have DKA phone 111.

Hi, I don’t pretend to understand why but I have keytones all the time, or at least had them on diagnosis, had them on a keto diet, went through ten keytone blood strips when I was told to monitor due to a tablet I was taking, regardless of the fact I was eating copious amounts of carbs at the time, my keytones range from 1.0 to can’t remember but about 3.5 I think. I’ve never not had them, luckily I get zero side effects from them as far as I know so perhaps some people just get them?

Nannynet said:

Hi I'm not on metformin, I'm eating normal amount of carbs, I'm not on any kind of keto diet, but my ketones go up after eating , or within a few hours, I can just go up to 1.00 with normal blood sugar range, I eat carbs on every meal, I haven't tried fasting, but I go up between meals, if I fast would be worse, so its a puzzle as if I go high blood sugars, I don't get ketones, I know I'm confused , I've never had ketoacidosis.

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The two main macro nutrients for energy are carbohydrates and fats. The body has no way of storing proteins so excess will be converted to glucose. The carbohydrate impact on blood glucose is relatively quick and large. The impact of excess protein is spread over a greater time period and lower. You could try increasing protein and see if that helps.

Ed: what blood glucose level do you have when you get symptoms? what rise in blood glucose are you talking about when ketones are sufficiently low for you to not have unpleasant symptoms?