Ketones present & fruity breathe. Advice please.

[Alisonjane10]

Hello folks

I need some advice please. My DN gave me Ketostix to periodically test my urine for Ketones. I did so this morning as I noticed my breathe had a foul fruity odour. The urineanalysis showed ++ medium range of ketones. Previous tests have shown a trace at the most, which I accepted was due to my LCHF eating plan. I tested my BG, and that's ok at 5.5 fasting. So, should I be worried? Can anyone advise me.

Ali. X

 

[Robinredbreast]

Hi, can you ring NHS 111, or ring your GP to get advice about what's going on. Your BS is good at 5.5, but there could be an underlining cause that may or may not be diabetes related ?

I hope you can get some helpful advice soon, take care

Best wishes RRB

 

[jack412]

I use numbers so I had to get my tub to see what ++ was ..it's about 4mmol

always consult a DR and what did your nurse say?

for me and not for you,
me being a T2 on oral with normal BG and I'm on LCHF with ++/ 4mmol would be ketosis.
also it's a fasting overnight measure..hydration alters urine concentration a lot, and 'starvation' ketones start to kick

I have my own ketostiks and I'd have some fluids and test after lunch. if still above 3, I'd eat some more there is no need to go above 2-3
* I found urine ketostiks worked better in the early stage, they show lower for me now but I'm still in ketosis, the blood sticks ones are more accurate.

 

[Spiker]

Generally NHS advice is that medium ketones are not a problem in the absence of high BG. If your BG was 13+ that would be a serious problem. As your BG is 5.5 that is not a problem, just a known effect of LCHF. This is called "nutritional ketosis" and it's what you want to happen in LCHF. It's very good that you are monitoring, do keep monitoring.

 

[diamondnostril]

As a person on Ketogenic/LCHF diet, BG of 5.5mmol/l and Ketones of ++ (4mmol/l) is what I'm aiming for. Would be pleased to get that every day.

 

[Alisonjane10]

I use numbers so I had to get my tub to see what ++ was ..it's about 4mmol

always consult a DR and what did your nurse say?

for me and not for you,
me being a T2 on oral with normal BG and I'm on LCHF with ++/ 4mmol would be ketosis.
also it's a fasting overnight measure..hydration alters urine concentration a lot, and 'starvation' ketones start to kick

I have my own ketostiks and I'd have some fluids and test after lunch. if still above 3, I'd eat some more there is no need to go above 2-3
* I found urine ketostiks worked better in the early stage, they show lower for me now but I'm still in ketosis, the blood sticks ones are more accurate.

View attachment 12597

Hi RRB & Jack412.

Thanks for your advice. My DNS has just telephoned & has given me a plan for the next couple of days. She doesn't seem too worried, which has made me feel calmer. DNS suggests the low carb diet & a poor appetite right now has increased the urine ketones. So, I'm to stop my Gliclazide for a few days & just take my Metformin. As long as my BG doesn't drop below 4.0 or rise into the teens, all should be ok. Phew!! Good call Jack412. I must admit, I haven't had a great appetite for a while. I'm finding it difficult to eat a varied diet on LCHF, & sometimes just skip meals/snacks as I'm bored with what I'm eating. I haven't got time to cook every meal from scratch & I'm fed up with cheese, nuts, eggs etc. I don't know if Metformin decreases your appetite, or whether it purely is just bored with my diet. I was hoping my diagnosis would become easier to manage with time, but it can be very frustrating & leaves me stumped. I know my mindset will have to change, and it will, but it's gonna take time. Many thanks for your kind advice. I do appreciate it.

Ali. X

 

[Alisonjane10]

As a person on Ketogenic/LCHF diet, BG of 5.5mmol/l and Ketones of ++ (4mmol/l) is what I'm aiming for. Would be pleased to get that every day.

Hi diamondnostril

Your avatar picture always makes my mouth water. It does look yummy.

Ali. X

 

[Alisonjane10]

Generally NHS advice is that medium ketones are not a problem in the absence of high BG. If your BG was 13+ that would be a serious problem. As your BG is 5.5 that is not a problem, just a known effect of LCHF. This is called "nutritional ketosis" and it's what you want to happen in LCHF. It's very good that you are monitoring, do keep monitoring.

Hi Spiker

Thanks for the advice. I've looked up nutritional Ketosis...makes sense now. BTW, how do I know if I'm consuming enough fat to ensure good brain function? Can you help with this query.

Ali. X

 

[Spiker]

Hi Spiker

Thanks for the advice. I've looked up nutritional Ketosis...makes sense now. BTW, how do I know if I'm consuming enough fat to ensure good brain function? Can you help with this query.

Ali. X

If you are not having a severe hypo then you have enough carbs for brain function. On LCHF your brain will prioritise carbs for your brain but also your brain (and nerve cells) will shift their metabolism so that they use less carbs than normal and rely more on other energy sources.

Basically, you don't need to worry about it. If someone told you that your brain needs X grams of carbs they were probably wrong. They confuse how many carbs your brain typically uses, with how much it needs. It needs a lot less than it typically uses. You may even feel more mentally alert when your brain is using fewer carbs - some people report that.

Edit: Doh, sorry you were asking about fat, not carbs. No idea, sorry.

 

[Alisonjane10]

If you are not having a severe hypo then you have enough carbs for brain function. On LCHF your brain will prioritise carbs for your brain but also your brain (and nerve cells) will shift their metabolism so that they use less carbs than normal and rely more on other energy sources.

Basically, you don't need to worry about it. If someone told you that your brain needs X grams of carbs they were probably wrong. They confuse how many carbs your brain typically uses, with how much it needs. It needs a lot less than it typically uses. You may even feel more mentally alert when your brain is using fewer carbs - some people report that.

Edit: Doh, sorry you were asking about fat, not carbs. No idea, sorry.

Helpful anyway Spiker. Thanks,

 

[Daibell]

Hi. Metformin is known to decrease the appetite to some extent. Apparently it started life as an appetite suppressent but it's effects vary between individuals.