High Ketosis, Low Ketosis; Does it matter?

Originally published June 11, 2017

There are various degrees of ketosis depending on your needs. According to the chart below a Glucose: Ketone Index (GKI) below 3 is “Therapeutic ketosis” that the medical profession uses to treat epilepsy and cancer. A range between 3 and 6 would be “Moderate/functional ketosis” and desirable for obesity, type 2 diabetes and insulin resistance. Lower on the index, between 6 and 9, is “low ketosis” and used for maintenance, optimal health, and weight loss. Anything above 9 there is no ketosis.

The glucose ketone index published report

From Wikipedia, we learn that “Ketosis is a metabolic state in which some of the body’s energy supply comes from ketone bodies in the blood, in contrast to a state of glycolysis in which blood glucose provides most of the energy.

Ketosis is a nutritional process characterized by serum concentrations of ketone bodies over 0.5 m/mol, with low and stable levels of insulin and blood glucose. It is almost always generalized with hyperketonemia, that is, an elevated level of ketone bodies in the blood throughout the body. Ketone bodies are formed by ketogenesis when liver glycogen stores are depleted (or from metabolizing medium-chain triglycerides). The main ketone bodies used for energy are acetoacetate and β-hydroxybutyrate, and the levels of ketone bodies are regulated mainly by insulin and glucagon. Most cells in the body can use both glucose and ketone bodies for fuel, and during ketosis, free fatty acids and glucose synthesis (gluconeogenesis) fuel the remainder.

Longer-term ketosis may result from fasting or staying on a low-carbohydrate diet (ketogenic diet), and deliberately induced ketosis serves as a medical intervention for various conditions, such as intractable epilepsy, and the various types of diabetes. In glycolysis, higher levels of insulin promote storage of body fat and block the release of fat from adipose tissues, while in ketosis, fat reserves are readily released and consumed. For this reason, ketosis is sometimes referred to as the body’s “fat burning” mode.

Ketosis and ketoacidosis are similar, but ketoacidosis is an acute life-threatening state requiring prompt medical intervention while ketosis can be physiological. However, there are situations (such as treatment-resistant epilepsy) where ketosis can be rather beneficial to health.”

How to make the calculation

Using a ketone/glucose meter you arrive at your m/mol of ketones and mg/dL of glucose by taking the measurement at the same time. You’ll have to convert the glucose mg/dL into m/mol. You do that by dividing the glucose measure by 18.016.

From my readings my glucose in m/mol is 4.55.  (82 mg/dL / 18.016 = 4.55 m/mol).

Then you divide blood glucose m/mol by blood ketones m/mol to arrive at the GKI, in this case, 5.05 (Glucose 4.55 divided by 0.9 of ketone). Therefore this morning when I woke up I was in a moderate/functional ketosis. Since I’m insulin resistant, this is a good level of ketosis for me. About a third of the time I’m in therapeutic ketosis (the blue level in the graph below) at less than a 3 GKI.

The above graph is my GKI since I started testing on April 26, 2017, through yesterday. Testing has allowed me to understand the number of grams of carbohydrates I can consume to keep me in these states of ketosis. I started out my ketogenic diet going through a 14-day ketoadaptation phase of only consuming less than 20 grams (net of dietary fiber) of carbohydrates and enough protein. After the 14 day period, I began to test and track my GKI results. I can tolerate about 40 net grams of carbs per day and stay in the yellow range. When I fast or consume less than 30 grams of carbs I move into the desired blue range for me.

Exogenous Ketones

Exogenous ketones are ketones produced outside the body. In a state of nutritional ketosis, your body produces its own ketones. To either lower the index or get in a state of ketosis without having to restrict carbohydrates, a person can consume exogenous ketones (β-hydroxybutyrate). I’ve used them before I went on a ketogenic diet and also while I was on the diet. On my diet when my liver is producing its own ketone bodies, supplementing with exogenous ketones will increase the amount of m/mol of ketones and thus increase the state of ketosis.

The brand I used was Ketond.com.

Weight Loss & Athletic Performance

I started my ketogenic lifestyle for two main reasons; to lose the weight that I had gained the last 3 years that traditional dieting could not remove because I’m insulin resistant and to race and compete using my own fat as fuel.

I’m happy to announce that I’ve released 16 pounds on the ketogenic diet with only about 5 more to lose to get to 10% body fat. Because fat metabolizes with less oxygen, I’m now starting to see my athletic performance increase. It’s great to be able to train and then to race without the need to put sugary gels and liquids into me (glucose). I don’t have GI issues and I won’t have to worry about bonking because my brain is not just relying on glucose to fuel it. The brain loves ketone bodies! In a state of ketosis, the brain is a happy camper.

For an individual wanting to lose weight if the brain is fed with ketones, your body gives up the lousy sugar cravings that going on a diet give you.

If you decide to explore and experiment with a ketogenic diet I recommend you invest in a meter that tests accurately your glucose and ketone levels. The unit I acquired has worked great. It was an investment of about $100 total for the meter ($28) and testing strips ($72). I now purchase my ketone test strips on eBay for about $1.72 a piece. Anywhere else, like Amazon where I first purchased my unit and strips, they run over $2.20 each. While each test can, therefore, run over $2 (glucose and ketone strips) the knowledge gained to really dial in your carbohydrate needs is invaluable.