Ketosis questions

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I recently got a KetoMojo glucose/ketone meter. To my disappointment, my morning measurements (after 12-13 hours of fasting) were in the range of 0.3-0.8 mM, with about half of the mornings being 'officially' in ketosis (ie at 0.5 mM or greater). I tried measuring a few times just before lunch - after 17 hours of fasting, and the results were either the same as in the morning or just 0.1 mM more, and yesterday surprisingly 0.2 mM more - morning was 0.6 mM, noon was 04. How can I be in ketosis more consistently? How do I achieve higher levels of ketosis - more in the 1 Mm area (so that even if keto mojo readings are off by a bit I will have a clear reading of ketosis)?


When people say they are keto-adapted, does this mean they are in ketosis all day long, every day? When are good times of day to measure in order to verify that? Most days I eat my first meal no earlier than noon, but sometimes an hour later, and I finish my last meal somewhere between 18:30 and 19:00. Between the two meals I often snack on a handful of almonds or cashews, or drink a glass of unsweetened almond milk. I also drink half a glass of kombucha around 17:00 if I am home, and just before dinner if I am just arriving from work.

[Tincup]

I recently got a KetoMojo glucose/ketone meter. To my disappointment, my morning measurements (after 12-13 hours of fasting) were in the range of 0.3-0.8 mM, with about half of the mornings being 'officially' in ketosis (ie at 0.5 mM or greater). I tried measuring a few times just before lunch - after 17 hours of fasting, and the results were either the same as in the morning or just 0.1 mM more, and yesterday surprisingly 0.2 mM more - morning was 0.6 mM, noon was 04. How can I be in ketosis more consistently? How do I achieve higher levels of ketosis - more in the 1 Mm area (so that even if keto mojo readings are off by a bit I will have a clear reading of ketosis)?

You may be interested in this Dave Asprey podcast with John Hopkins Prof & former NIA lab chief Mark Mattson (Mattson has been studying fasting at the NIA -part of the NIH- forever). Mattson noted there is a two phase ketone response, much of it below 0.3 mmol/L BHB (can only see this on lab, not home testing). Also, it turns out the "official" keto graph:



is from Stephen Phinney MD PhD. When Aussie engineer, Marty Kendall, asked Steve about it, the source was from two studies done in the early 80's with people who'd only "adapted" for 4-6 weeks. Turns out the longer you are adapted, the better the body is at using ketones and the less that stay in storage. Read Marty's blog on this.

When people say they are keto-adapted, does this mean they are in ketosis all day long, every day? When are good times of day to measure in order to verify that? Most days I eat my first meal no earlier than noon, but sometimes an hour later, and I finish my last meal somewhere between 18:30 and 19:00. Between the two meals I often snack on a handful of almonds or cashews, or drink a glass of unsweetened almond milk. I also drink half a glass of kombucha around 17:00 if I am home, and just before dinner if I am just arriving from work..

I've been keto adapted since 2009. In my definition is I usually test some (usually 0.5 mmol/L or more) BHB on a morning fingerstick test ~12+ hours fasted. Also, that if I do a multi-day fast, I never have to go through keto flu (did in 2009). My glucose just drops into the 50's (mg/dL) and ketones rise into the 4-8 range.

I look at having even minor levels of BHB as an indicator that insulin is low, which is my goal. Some people will notice a cognition difference if their BHB is below a level (say 1.0 mmol/L). I can't tell a difference between 0 and 8.0 mmol/L in my cognition. Also folks with cancer or epilepsy may have a requirement for certain levels. For me, I just look at myself as a "dual fuel" being, like a hybrid automobile and my body will use whatever it has/needs at the moment. If you really care, breath acetone is likely a better indicator of real time ketone production. I eat a fairly high fiber diet, and my acetone meter sensor will spike on methane - which my gut bugs make plenty of from the fiber. So my meter is really only useful, with my diet, during an extended fast. I think some meters may have a more finely tuned sensor.

Absent a need to have BHB at a certain level, sounds like you are doing just fine! If you do need more, then supplementing with caprylic acid - C8 from MCT oil, will likely do the trick. I do know a woman who is 7 years past diagnosis with a brain cancer and was given 12-18 months initially. She had the tumor resected, but declined chemo & radiation. She maintains her BHB > 4.0 mmol/L with low glucose, while eating. I can do this on extended water fasts, but haven't tried to push it while eating (and have no need to).

[Tincup]

When people say they are keto-adapted, does this mean they are in ketosis all day long, every day?.

The emerging consensus (absent a strong reason otherwise) is to not be in ketosis all day every day, but the best course is to move back and forth into and out of ketosis, even within a day - metabolic flexibility.

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You may be interested in this Dave Asprey podcast with John Hopkins Prof & former NIA lab chief Mark Mattson (Mattson has been studying fasting at the NIA -part of the NIH- forever). Mattson noted there is a two phase ketone response, much of it below 0.3 mmol/L BHB (can only see this on lab, not home testing).

Read Marty's blog on this.

Thanks Tincup, for these resources. This was very helpful.

I've been keto adapted since 2009. In my definition is I usually test some (usually 0.5 mmol/L or more) BHB on a morning fingerstick test ~12+ hours fasted. Also, that if I do a multi-day fast, I never have to go through keto flu (did in 2009). My glucose just drops into the 50's (mg/dL) and ketones rise into the 4-8 range.

How long do you fast for? How long does it take you to reach these levels of glucose and ketones? What benefits are you aiming to achieve with this type of fasting? I once tried fasting for longer than my daily fasts, I went 40 hours. Woke up in the middle of the second night tasting acetone in my mouth (but I did not have any way to actually measure my levels then).

Absent a need to have BHB at a certain level, sounds like you are doing just fine!

Thanks for the reassurance! My glucose levels on these mornings were in the range of 63-88 mg/dl (3.5-4.9 mM).

[JD2020]

I'm not doing the keto food plan for now because, as I have posted in these pages, the weight loss is not manageable at this time. My question is about MCT oil. Is there a best time to supplement with it? For example, ketones and carbs should not both be rising at the same time, correct? If correct, then it seems to me that AM is not the time for me to supplement with MCT oil because I get a lot of carbs with my dairy (A2, organic, pasture raised, but still, carbs).

Do I wait a certain # of hours post breakfast?
Supplement with or without food?
Or does none of this matter?

Thanks,