A New Toy Measuring Blood Ketones


I just got a new toy: a device for measuring blood ketones. This is a far more exact and reliable measurement than testing for urine ketones using cheap dipsticks. Ketosis is of course the state the body is in when eating very low carb. Ketones, made from fat, will then fuel the brain instead of glucose.

So who needs one of these gadgets? Perhaps nobody. Obviously it’s easy to eat LCHF without it. This is for curious nerds (like me) and for those who want definite proof that they are eating so little carbs that insulin levels are low and fat burning is maximized.

A ketone level somewhere between 1.5 – 3 is said to be an optimal level for maximizing weight loss. It means that insulin levels are very low. As you can see my first measurement was 0.2, after a caesar sallad dinner. I’m not surprised as I’ve probably eaten at least 50 grams of carbs a day lately.

I will try it out fasting in the mornings during the coming days. Perhaps I’ll try being really strict with the carbs for a while to see what happens.

Have you tried one of these or are you interested in doing it?

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Top Comment

  1. Willis Morse
    After a huge weight loss and health improvement five years ago with very low carb, I've been backsliding in weight gain and health for the last few years, despite rigorous very low carb diet. I got this meter and lo and behold, I wasn't anywhere near ketosis. As soon as I cut WAY back on protein, a la Volek/Phinney/Moore, I start going into ketosis again. I've played with this up and down a couple of times now, and it's totally repeatable even over a single day. I had to drop from an average of 150g protein/day down to around 70g protein/day. That's pretty close to the "0.5g protein/lb lean body weight" amount suggested by Volek and Phinney.

    Also, my fasting glucose dropped when I dropped the protein. It bounces around a lot, but the trend seems to be upper 90s before, low 80s afterwards.

    It doesn't seem to matter how many calories I eat, or how much fat I eat. Ketosis seems to be directly tied to the ABSOLUTE amount of protein and carbs I eat. Once I've hit my protein and carb limit for the day, I can stop eating or I can guzzle pure fat; it doesn't matter. This holds true whether I eat 800 or 1600 calories in a day. It basically means I have a meat and eggs budget for the day (my two largest sources of protein).

    I don't think it's really about the macronutrient ratio in your diet. I think it's about absolute amounts that you can tolerate. I think focusing on percentages of macronutrients just confuses the issue; if you eat 70g of protein each day, the daily percentage of protein will change if you eat 800 calories one day and 2000 the next. Percentages only make sense in the context of a constant number of calories. It's not mathematically incorrect to talk about percentages, it's just a more indirect way to calculate things. Just like expressing your carb limit as 20g/day; it's much simpler to track.

    I bought the ketone strips from the Canadian pharmacy that Jimmy mentioned in his original post. Much cheaper, but they did take almost a month to arrive. But even at high US $ rates, I think a pack or two of strips is a worthwhile investment if you aren't already dialed into steady weight loss.

    Replies: #105, #108
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All Comments

  1. Brenda
    I am running HI ketones (over 8) my meter will not read it at all. I have eliminated all carbs, starches and dairy products. It is driving me crazy! I lost 14 pounds in four weeks and I am 136 pounds at this time. Has anyone experience such a high level of ketone burning and is it good? Should I be concern? My doctor doesn't believe in any of this stuff, but his diet didn't work in 10 years.
  2. Zepp
    Yes, its starving ketosis or type 1 and to litle insulin!

    Now that you know that, what is you going to do about it?

    Are you type1?

    Up to 6 is starving or post excersise ketosis!

    Optimal diet induced ketosis is 1-3.

    10 or over is typical type 1 and if you go further one can get keto acidos!

  3. Lauren
    Ok so I am diabetic and I know for a fact that ketones in your blood are life threatening. NEVER try to get your ketone levels up. If they are above 0.6 you require immediate medical attention. It's very serious. If you want to lose weight do not have low carb diets just eat the amount of carbs you require. It will differ for everyone depending on exercise and size what amount of carbs you should be having but you should definitely not have less carbs. This leads to type 2 diabetes. If you wanna lose weight see your doctor for help.
    Replies: #154, #155, #167
  4. Misko
    Thanks for your concern, Lauren. But if you browse thru this blog and do some research on "ketosis", "nutritional ketosis", "ketogenic diet", etc. and look for the works of Dr Stephen Phinney, Dr Jeff Volek, Dr Peter Attia, Dr Andreas Eenfeldt, and many others on this subject, you'll learn that many many people are in the best shape of their lives on this diet.

    I've personally been eating a high fat very low carb moderate protein diet for almost eight months now and I'm in the best shape of my life, both physically and mentally, and so our countless others.

  5. Galina L.
    Dr. Bernstein( who is D1 since 12 years old recommends no more than 30 grams of carbohydrates a day for diabetics( He is 80 years old now, still working treating diabetics.
  6. Tim
    Hi, Ive been following low carb and Keto for a while now but I only recently bought a glucose/ketone test meter. Although I thought I was doing everything right I struggle t get into ketosis. My carb intake is around 30 g per day,and protein around 80g. I have been in and out of ketosis for about 6 weeks. I seem to take ages to get in and then drop out really easily.
    Just because I had the test meter I started to test my blood glucose and its really high in the morning 120.6 to 145 it then drops slightly during the day. I'm really at a loss to explain it. I seem to be bordering on type 2. I'm 53 I cycle every weekend and train at least twice a week on the bike and lift weights on the other days. I weight in at 153lb. Should I be worried about the high glucose readings? and is the high blood sugar preventing ketosis?
    Replies: #157, #158
  7. sten
    This is THE problem after a while! Google Jimmy Moore as he solved it for himself, but with a lot of efforts, like workouts and limiting protein intake after mid day, also limiting carbs then of course.
    Our livers make glucose from protein during sleep...., and it seems the worse metabolic syndrome the higher it gets in the mornings.
    Proteins and a glass of wine to evening dinner helps, which can compensate when eating out I also found that some raw vegetables - organic of course to avoid increased load of primarily glyphosate toxin (roundup) that is heavily used on all non-organic plants - was lowering the dawn phenomenon! Re ketone meter; Not really needed until morning BS is close or below 100!

    BS over 5.5 (100) to 6.9 (125) is regarded prediabetic.
    Here blood vessel damages also start, although slowly but making it important to get out of it quickly!

    Welcomes like you more and better advices how to solve this problem permanently.
    Diabetics have these problems all the time of course.

  8. Zepp
    Morning sugar shall be higher then other fastig sugar!

    Its part of your cirkadian cycle and cald Dawn phenomenon!

    Its linked to Cortisol awakening response.

    So take a A1c and se if that is better?

    Reply: #159
  9. sten
    Dawn phenomenon induced by cortisol that drives fasting BS over 5.5 it is regarded prediabetic. Something to avoid as it has potential consequences on eysight, hearing, dementia and blood vessels in general through plaque building. I guess when plaque builds in our finest blood vessels it can be measued through how hearing of higher pitch tones disappears; what goes at the same time we can guess. Progressively "everything" goes the same way. As I see it the speed depends on average blood sugar which is also measured with HbA1c.
    Reply: #162
  10. Nan
    @Tim- I had to drop my carbs below 20 per day, and then my over-all calories. My BG dropped from around 95-100 to the 80s, but my ketone response was unimpressive (I use the PrecisionX tone meter). I was taking in too much fat, though adequate protein, which means my body didn't need to dig into its reserves. Now, having adjusted my calories down, my AM fasting ketones register at around .5-.7. I am in late middle-age, which matters, and had become insulin resistant, so just going low carb wasn't enough, despite a regular exercise schedule with hit weekly and regular long walks 2-3 miles. I wish more emphasis would be given to the metabolic spectrum and that while most people can do the basics and get good results, some of us, like Jimmy Moore, have to work harder and be strict to get any results. I would love to not have to count calories, but contrary to what Dr. E has stated, some of us do have to monitor caloric intake, along with everything else, and closely.

    Reply: #161
  11. sten
    Thank you for that comment. One of the "last nails" in the coffin of the metabolic syndrome I think, calorie reduction.
    And once the visceral fat is burning - through cutting also the fat intake as you say - one must carry on to a level well below what measures as metabolic syndrome, which can be tough I think.

    Visceral fat that comes and goes with the seasons is probably an asset while the same stuff sitting in the same place for years becomes more of a culprit. If the fat also store toxins over time our bodies are probably also reluctant to let it dissolve back into the circulation. (kind of taste, spit and avoid also at that level ?) ( A nasty longer time dimension living around too much environmental toxins)
    Yet once that journey is over - if we ever get there- I think the problems associated with the MS vanishes, as showed by the Newcastle doctor that measured VF before and after a seriously reduced carefully supervised low calorie diet:
    Then diabetes and visceral fat disappeared together!
    But because none of those (all diabetes 2) test subjects practised LCHF or similar, 99% or all returned to diabetes within a short time after the trial.
    Yet the connection was proven.

  12. Zepp
    Yes it is.. but one cant do anything about ones cirkadian cycle.. more then try to be less insulin resistante and to be healtyer.

    A better prediction on prediabetes is postprandial glucose levels.

    It can take 10-30 years to develope full diabetes.. faster if one realy tryes!

    The thing to know about Dawn phenomenon is that it is by cirkadian cycle that rise glucose levels by excreting mostly cortisol.. if one tryes to lower it by taking more insulin, the body excret more cortisol and then one can get a fluctuating glucose level the whole day.

    Best approche still seems to be to take a swift walk early in the morning, to signaling that the dawn is gone.

    Reply: #163
  13. sten
    Hi Zepp, thanks for your reply, keeps the minds going!
    I personally am not concerned with diabetes, yet my entry to LCHF came from heart disease which usually comes with prediabetes, so I am concerned that I will not fall back down in that angina hole that LCHF cleared me 100% from. My heart calcium score scan values had increased slightly between 2006 and 2014 and angina went with LCHF in January 2012, so it may well have increased before 2012. But better safe than sorry especially in a deadly matter like this.

    There are of course other things at play than the circadian cycle. I think we all agree that the blood sugar is not meant to rise over 5.5, and it is one indication of prediabetes when it does, although A1c and glucose challenge are others.

    Here I will attempt to make a simple explanation for thr events, as I see it. Other facors may of course be at play but I think this one may be the prominent one. Not proven!

    When BS rises too high in morning it can be due to poor metabolism or lack of natural melatonin or melatonin does not work as it should. Or mayb poor thyroid.
    In younger people and healthy older it is normal that after some hours sleep capillary blood vessels are dilated. The noticable effect is a feeling of warmth in limbs, particularly in feet. The reason for it may be regular maintenance, and maybe all capillaries open up like this at the same time, in essence to open the smallest vessels for "clean up" to prevent early blockages.
    But the effect is only noticed in the capillaries in the skin, are noticed through the warming up of the skin. A second side effect -that realets to the blood sugar usage - is that when the body cools down as a result of the transport of warm blood into the cappillaries of the skin, the overall body temperature is reduced and energy is required to compensate for this! The core body temp reduction can be 0.25 degree while normal warming in skin can be + 2 degrees. To maintain homeostasis extra energy must be provided, supplied by deafult as part of the package?

    Hence when this nightly opening up of capillaries is dysfunctional to any degree, the result maybe that the unused energy results in raised morning blood sugar.

    A major manifestation is cold feet through most of the night. A quick and maybe lasting fix I found is some vinegar late at night, before teeth brushing as the acidy stuff definitely can harm the enamel.
    I now found that there is a well known positive correlation between cold feet and diabetes, which for us prediabetics may mean high morning blood sugar...

  14. Jennifer
    I agree with Nan. I am a 63 yo female and have been eating very low carb, high fat, moderate protein for over two years. I've lost 45 lbs and want to drop another 15. I was totally stuck until I started taking glucophage xr, maximum dose at bedtime. Exercise is crucial, and has to be pretty strenuous. Even on glucophage my morning blood glucose can be in 80’s or. . . frustratingly, low 100’s. Carbs have to be 20g maximum. Protein only 40g to lose. Calories between 1000-1200. It's tricky. My triglycerides are still 191, hgba1c is still 5.4 so obviously my blood glucose isn't consistently down enough.
    On the upside! LCHF is doable. I'm not hungry ALL the time. I no longer have uncontrolled asthma or need a cpap at night. My clothes fit again. In fact, I need to go shopping because they're too big.
    But it's not easy for me either. It's a constant challenge.
  15. Marcia
    I just started using the monitor and want to be clear on the targets. I was at 0.3 yesterday and 0.6 this am.
    Please confirm the target is 1.5 - 3.0 for optimal weight loss.
    thank you.
    Reply: #166
  16. Zepp
    Yes, yes.. its the optimal range.. for banting!

    Thats what happens for moste people if the is able to eat low carb and high fat.. plus that you use body fat.

    The thing is, that numbers dont tell that much.. but its a funny tool, and you can test what happens when you do this or that.. or if you eat as you think you do.

    Use it the best way.. eat what you think is a proper diet for your goals.. then take morning tests and read how it developes!

    If one drink more water in the night, then ketones can be diluted!

    Dont even think that keton samples is the real thing.. its a tool for helping you on the right track.

    Roughly.. the more fat% and calorie reduction the more ketons.. but I think you did understand that?

  17. Toni
    There is a difference between ketosis and ketoacidosis. Ketoacidosis is a dangerous condition, where toxic levels of ketone bodies build up in the blood because the body is not producing insulin. Ketosis, on the other hand, results when the body has exhausted its stored glycogen and begins to burn fatty tissue for energy. They are quite different. And ketosis is very safe and has helped thousands not only lose weight, but get their type II diabetes, pre-diabetes, and insulin resistance under control. In fact, most have completed cured themselves of them.

    Are you a type I or type II diabetic? Type I you are genetically predisposed and not much you can do but control it. Type II on the other hand is completely controlled by diet. If you have type II, you should eliminate all sugars and carbs and increase your fat intake. You won't be hungry and your insulin will level out. If your blood sugar is ever high, I guarantee it's because you ate or drank something that was too high in sugar or carbs for your body to process. The only way to control an insulin spike is to not eat or drink anything that will spike it.

  18. Rafael
    I've been in ketosis for about 5 weeks but never get the ketones level higher than 0,9 in the morning, despite the daily 1 to 2 hours of running and weight lifting and low carb and high fat diet. After exercise, my levels aren't better. What's going on?
    Reply: #169
  19. Zepp
    It could be that you used them?

    And its altso a matter of what you measure, Acetone, Acetoacetate or Beta- hydroxibutirate.

    One measure only one of them whit different measuring devices.

    So the other two can be higer?

  20. Michael g
    All that matters is you're in ketosis. Ketone levels will even vary by the time of day you check them. If you have any ketone in your body you are indeed burning body fat.
  21. Terese
    You should check your ketones in the evening before going to bed.
  22. Maggie Mumford
    Where can i buy it and how much.thanks
  23. Adam
    Afternoon all! So, out of sheer curiosity, I've just decided to test my blood ketone levels three times in a row. Each sample of blood was taken from a different finger. The readings...

    1) 0.4 mmol
    2) 0.9 mmol
    3) 0.7 mmol

    As you can see, there's considerable shifting in the results and this was over a period of five minutes!

    Is this normal?


  24. Zepp
    Some points up and down is normal variation!

    I think that morning tests after a whole níghts fasting make it higher?

  25. Martin
    Is anyone here consistently getting readings over 1.5 mmol? For example, like Jimmy Moore. Trying my hardest, but my afternoon readings max out at about 1.1 mmol. Any advice is appreciated!
    Reply: #177
  26. Stephen
    Martin. The only time we get blood ketones levels above 1.5 -1.8 is when we are fasting. I get 1.9 after a 24 hour fast. My wife has reached 3.5 after a 48 hour fast. My normal LCHF non-fasting level is about 1.5. Anything above zero is proof that you are burning fat, not glucose.
  27. Zepp
    1,1 is still a good reading.. for a ketogenic pretender!

    It means that you dont eat to much carbs/your glucose levels are not very high.. probably not your insulin levels either!

    And on top of that, if you fell fine and if your food is tasty.. thats a lifestyle that one can coop whit.. isnt it?

  28. Martin
    Stephen and Zepp...thanks!
  29. Kim
    What meter do you guys use? Where did you get it? I have always just used the test strips but want to get more precise with measuring ketones. Thank you.
    Reply: #181
  30. Terese
    I am a 65-year-old post-chemo woman. I've been doing LCHF for 7 months now and have only lost 17 (of 100) pounds. My ketones have never been above 0.7. My glucose has been as low as 77 and ranges all over the place to a high of 132 since I've been on LCHF. Am I being impatient about the weight loss? I will scale back my protein but I'm near 0 gm carbs per day. Any advice would be appreciated. Thanks.
  31. Terese
    I use the Abbott Precision Xtra but it is one of the most expensive for ketone strip refills. The last time I bought the strips they cost $68 for 10 strips. I use them sparingly. Others use a different meter that is less expensive but it doesn't measure as accurately below 1.0. Since I've only been as high as 0.7, that meter did not work for me. Check out Maria Mind Body Health for another recommendation.
  32. Stephen
    Terese. I don't know where you are getting your Abbott Precision Xtra strips, but I buy mine from Amazon and paid $29.95 for 10. The price does vary but is much lower than what you are paying. I see they are selling for $34.95 now. (free shipping)

  33. jim
  34. Sheila
    How do you eat LCHF & limit the protein? Doesn't eating a very low carb mean eating only protein? I have been dieting since Dec 2014 & following very strict low carb since April 1, 2015. Since December 5, 2104 I have lost 50 lbs. 8 weeks ago my UA showed 2+ ketone & most recently 1+. I was diagnosed a type 2 diabetic in April 2014 & now have normal fasting BS. I also walk on the treadmill 5 to 6 days per week 2 - 3 miles over a period of 45 to 70 min. I would like to lose 20 more lbs but need to lose only 4 to be at a normal bmi. Any suggestions?
    Reply: #188
  35. Chelsea
    I've been following a strict LCHF diet for 26 days now and my blood keto levels were checked for the first time yesterday at 5pm and read just 0.3 mmol/L. I re-checked my levels this morning after fasting for 12 hours same result. I've also tracked my food intake via food zone and it confirmed I was eating between 20 to 30 grams of carbs per day. I really don't think I can go any lower, I do not eat any fruit, tubers, grains, breads etc. I am female, weighing 54kg, and 165cm tall. Any suggestions as to why my reading is so low, given that I'm being quite strict?
    Reply: #186
  36. Apicius
    Too much protein in your diet can prevent ketosis. This is because the body can compensate for sudden reduction of carbs in food intake by still getting an insulinogenic response when you eat lots of protein. The body can then take the protein and convert it to glucose (sugar) via a biochemical process called gluconeogenesis.

    Try this...reduce your protein and increase fat (from natural sources only, like butter, egg yolks, lard, bacon, etc). Stay far far away from highly processed forms of fat, like vegetable oil or margarine. Eat only the natural and low processing forms of fat.

    High fat content in your meals (like +80% of calories) with intermittent fasting, and drinking lots of water or bone broth will force your body into ketosis.

  37. Jeanette
    Good day,
    were do you by the keto tester and what is the price.
  38. Zepp
    "Doesn't eating a very low carb mean eating only protein?"

    No it means High Fat.. high as for your energy demand!

    Protein is mostly a building stone for a lot of importante things.

    If one like, one can spell it.. LCHF Normal Protein!

  39. Marko
    I been doing low carbs diet and I been having readings from 0.4 to 1.3 keton. Im an martial artist professional athlete, and I do have to eat carbs during and after training, my problem is that I always start my morning with 0.4k and in the afternoon goes up to 0.9 - 1.3. But some days I stay in 0.4 and only go up to 0.6

    How I can do to be in the morning higher readings? can I get into 1.3-2 if Im eating carbs for my trainings??

  40. Vicky
    I am new in this LCHF diet, but I have been kinda of living a LC life for the past few years.
    I am 5'2 weighting today147 lbs.
    Iam in my middle forties, type 2 diabetic, taking metformin 1,000 mg a day. Actually I just started taking it again , I have been controling it with diet for the past five years, but my last A1C was 7.5 and doctor said to start taking it till I loose weight again.
    Yes, I was 132 last december, but shit happen and I am an emotional eater.
    I started LCHF diet on Sunday. I have been eating delicious food (better than never). I am a swim instructor for babies, so I kinda of active all day long but I do not excercise much, except for fast walks twice a week.
    I purchase some urine strips to see if iam in ketosis, and it show that I was moderate.
    I just received my glucose and ketone machine.. and of course I have to use it.
    I have lunch at 1 pm, so it has been 4 hours. It was a 771 calories lunch, with 32 g protein, 64 g fat, 8 g net carb (20 g total)
    Iam using myfitnesspal food diary to manage my macros. At this time my daily goal is carbs 5%, Fat 75%, Protein 20 %. in a 1,200 - 1,400 cal diet.
    My readings are Ketone : 2.9 Glucose: 89 ( same reading this morning fasting but last night i forgot to take my metformin).
    I didnt have any keto flu, but I do drink a lot of water, been taking potassium and magnesium...
    and I do not have a vitamin D deficit.. Iam a floridean working in the sun all day 😉
    But the lastblood test showed that I am a bit anemic.. hopefully the grass feed meat will do the trick.

    If anybody have an input or any advise, I will like to hear it, because I am doing this from reading, researching online and past experiences.
    I used to weight 187 lbs and lost 47 lbs doing a hcg diet. Today I am 7 lbs fatter that my last weigh on hcg five years ago, but also have less hair. LOL

  41. Paul
    Just throwing in my own experiences in case they are a help to anyone... I am 64 and always exercising... And I am an accomplished dieter over my lifetime. I have a number of times lost 40 pounds and achieved a normal BMI (it helped to bicycle across the continent a few times, admittedly.) Alas I am also an accomplished weight gainer. Generally my good weight would last, oh, 18 months or so and then something -- a life stress of some sort or even a particularly dark span of late fall weather -- would have me reaching for comfort food and inexorably the weight would climb back on.

    3 years ago I was desperate. I discovered my fasting glucose of 106 was bad -- (doctor never said a word), my triglycerides at 300, and various other parameters were scary. But it was my expanding waistline that really troubled me. I had been a semi-vegetarian for many years. How could everything be so out of control?

    I threw caution to the wind and began a low carb diet. For the first time in many years I was eating red meat, butter, cheese. I fully expected in six months on this diet my cholesterol and triglyceride would test at something like 1,000... But I wanted to get thinner at any cost. (Even if it killed me, I guess.)

    It was the easiest weight loss ever. I never had cravings. I didn't stare at ads for frozen veggie pizza any more, didn't even care about it!

    I bought the urine test strips (was able to slice each strip into thirds to save money) and they showed I was in ketosis. No hunger. Skipping meals -- no problem. I lost 45 pounds easily. On long bike rides with friends I'd watch them get ravenous and scour gas station marts for burritos, candy, energy drinks, while I waited outside with no hunger, nibbling on a piece of jerky or a hard-boiled egg.

    Anyway, in six months my fasting glucose was at 78, triglycerides at 74, HDL over 80, the cholesterol ratios were insanely good.

    I definitely got the low carb message. But I never really caught the moderate protein message. After awhile, my loss stopped (I was aiming for that super fit abs look -- never quite got there). The urine strips generally showed few ketones.

    The miracle for me, though, was I wasn't gaining like before. I had always been the type who was either gaining or losing, never static. Now I was pretty static.

    Fast forward a couple years, still on a low but not super-low carb cuisine. Yes, a few pounds came back on. Maybe at 1/8 my historical post-diet rate of weight gain. I was puzzled why any pounds were coming back on. Since the urine strips no longer worked for me I invested in a breathylizer unit called Ketonix ($150 or so.) I would puff into it and it showed I was in ketosis after all but to a light or moderate degree -- no matter how low my carbs got.

    So what was going on? Many who are reading this probably know the answer. I was eating too much meat and cheese. I was eating enough protein to partially activate my underlying metabolic syndrome problem ( and I do mean partially -- nothing like the way I was before.). So I burnished all those low-carbohydrate books I'd downloaded and found the chapters I must have skimmed earlier. (I was having success on low carb-- why worry about protein at all?). Jimmy Moore's book really pointed the way.

    To cut to the chase, I cut proteins to half or three-quarters of a gram per pound of body weight (it's quite surprising how just a few too many ounces of chicken or steak jumps daily protein way over that level!) Watching total calorie intake, too, of course. But within days the Ketonix LEDs were flashing red (a high ketone result) corresponding to a blood level of about 4 or 4.2. Pounds began dropping away and in a week clothes were already fitting better.

    Everyone's different... Individuals vary on how sensitive they are to carbs and perhaps to protein. But the lesson for me was: low carb is an incredibly effective tool, but protein is that little gremlin dancing on the airplane wing (famous Twilight Zone episode) and it can do a frisky little sabotage on your weight control.

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