Lose weight by achieving higher ketone levels
Before we get started, here’s a short recap of the tips so far: The first and most crucial piece of advice was to choose a low-carb diet. The next were eating when hungry, eating real food, eating only when hungry, measuring progress wisely, being persistent, avoiding fruit, beer and artificial sweeteners, review your medications, stressing less and sleeping more, eating less dairy and nut products, stocking up on vitamins and minerals, using intermittent fasting and finally, exercising smart.
This is number sixteen:
16. Achieve higher ketone levels
Warning: Not recommended for people with type 1 diabetes, see below.
We’ve now arrived at tip number 16. If you’re still having trouble losing weight, despite following the 15 pieces of advice listed above, it might be a good idea to bring out a controversial option: higher ketone levels.Ā Why is it controversial? For most people, “low” or “higher” ketone levels don’t make a difference for health and weight loss, and in general we do not recommend shooting for a specific ketone level. However, for some people stalling at weight plateaus while on a low carb diet, trying to raise ketone levels may be of benefit.
So how does this work? A quick run-through: The first tip was to eat low carb. This is because a low-carb diet lowers your levels of the fat-storing hormone insulin, allowing your fat deposits to shrink and release their stored energy.1 This tends to cause you to want to consume less calories than you expend – without hunger – and lose weight.2 Several of the tips mentioned above are about fine-tuning your diet to better this effect.
Video course
Do you know how to eat a well-formulated low-carb diet? This is required for ketosis. Learn how by watching this high-quality 11-minute video course on how to eat low carb, and the most important things to think about.
Sign up for our free newsletter and you’ll get instant access to it:
The newsletter arrives once a week with unbiased information free from ads or industry influence. Your email is kept 100% private. To unsubscribe just press “unsubscribe” at the bottom of any newsletter.
Ketosis
Ketosis is a state at which the body has an extremely high fat-burning rate. Even the brain indirectly runs on fat, via ketone bodies. These are energy molecules in the blood (like blood sugar) which become fuel for our brains after being converted from fat by the liver.
To encourage ketone production, the amount of insulin in your bloodstream must be low. The lower your insulin, the higher your ketone production. And when you have a well-controlled, sufficiently large amount of ketones in your blood, it’s basically proof that your insulin is very low – and therefore, that you’re enjoying the maximum effect of your low-carbohydrate diet.3
Measuring ketones
Today, there are reasonably-priced gadgets available for measuring ketone levels at home. One needle prick of the finger, and in just a few seconds you’ll know your blood ketone level.
Blood ketones are best measured on a fasted stomach in the morning (before breakfast, that is). Here are a few pointers on how to interpret the result:
- Below 0.5 mmol/L is not considered “ketosis”. At this level, you’re likely not in your fat-burning zone.4
- Between 0.5-3.0 mmol/L is nutritional ketosis. This is where you see the beneficial effects on weight and metabolic health. For most people, it won’t matter where in this range you fall
- Around 1.5 ā 3 mmol/L is the upper end of nutritional ketosis. If you have hit a weight loss stall without a clear reason, one possible intervention is to increase your ketone levels. Although there is no scientific support for this intervention, rare cases may see benefit.
- Values of over 3 mmol/L aren’t necessary. That is, they will achieve neither better nor worse results than being at the 0.5-3 level. Higher values can also sometimes mean that you’re not getting enough food. For type 1 diabetics, it can be caused by a severe lack of insulin, see below.
Ketones in urine
Ketone levels can also be measured in a more old-fashioned way, with urine test sticks (sold prescription-free in pharmacies or on Amazon). Ketone sticks give less reliable results for several reasons, and the above recommendations can’t be straightforwardly applied to them. They are, however, much cheaper.
My personal experience
Feel free to read my accounts of a two-month personal trial:
- Experiment: Higher ketone levels for weight loss and increased performance
- Four weeks of strict LCHF and ketone monitoring
- Final report: Two months of strict LCHF and ketone monitoring
Although I was quite happy with my weight before these trials, they resulted in a further loss of 4.5kgs (10 pounds) and 7cm (3 inches) around my waist – without additional exercise or even the slightest resemblance of hunger.
How to achieve higher ketone levels
Many who firmly believe they are eating a strict low-carb diet are surprised when they measure their blood ketones. They may be at around only 0.2 or 0.4. Why?
The trick here is to avoid all obvious sourced of carbohydrate (sweets, bread, spaghetti, rice, potatoes), consider time restricted eating, and use fat as a lever for taste and satiety.
Sometimes adding MCT oil to your coffee or tea can help increase your ketone levels which may or may not resolve your stall. It may not be “magic” for everyone, but for some it may just do the trick.
If it doesn’t work
Having higher ketone levels for a prolonged period of time (say, a month) will ensure that you experience the maximal hormonal effect from eating a low-carb diet. If this doesn’t result in noticeable weight loss, you can be certain that too many carbs are likely not part of your weight issue and not the obstacle to your weight loss. There are, in fact, other causes of obesity and being overweight. The next three tips in this series might help you.
Also, consider signing up for our Weight loss for good program, free for Diet Doctor members!
Try it
Order a ketone meter online and start measuring. There are a few different models, the most popular one is probably the Precision Xtra ketone meter. Unfortunately these meters are all quite expensive to use, as the test strips can cost about $5 per test.
Here’s a complete package with everything you need to check your blood ketone levels.
More
Learn much more about ketogenic diets here:
A ketogenic diet for beginners
Watch my video interview with Dr. Peter Attia, on a strictly ketogenic low-carbohydrate diet: Very Low Carb Performance
Read all the tips on the How to lose weight page.
Ready to lose the weight for good?
Our new 10-week program helps you lose weight in a healthy and sustainable way.
Sign up now!
A word of warning
If you have type 1 diabetes, you should not follow the above advice to purposefully increase your ketone levels – it may be risky. If you have ketones in your blood at all, you must be sure that your blood sugar levels are normal. If they are, you’re in normal ketosis – just like the ketosis of healthy people who stick to a strict low carb diet.
High blood sugar levels coupled with high blood ketones, on the other hand, will mean that you have a pathologically low level of insulin – something non-diabetics do not suffer from. This can lead to ketoacidosis – a potentially life-threatening condition. If this happens, you’ll need to inject more insulin; if you’re at all unsure of what to do, contact a medical professional. Coveting really high blood ketones for weight control is not worth the risk for type 1 diabetics.
The Journal of Nutrition 2015: A lower-carbohydrate, higher-fat diet reduces abdominal and intermuscular fat and increases insulin sensitivity in adults at risk of type 2 diabetes [randomized trial; moderate evidence]
Annals of Internal Medicine 2005: Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes [non-controlled study; weak evidence] ↩
Journal of the American Dietetic Association 2005: Perceived hunger is lower and weight loss is greater in overweight premenopausal women consuming a low-carbohydrate/high-protein vs high-carbohydrate/low-fat diet [randomized trial; moderate evidence] ↩
Current Nutrition Reports 2018: Nutritional ketosisĀ for weight management and reversal of metabolic syndrome [overview article; ungraded] ↩
Some controversy exists for this cut off level as few head-to-head trials exist comparing low levels of ketone production. Some studies have shown benefit of a ketogenic diet with ketone levels as low as 0.3mmol/L. ↩
478 comments
I am on keto diet, I did a ketone blood test and it reads 5.9 is it okay?
As long as you are not diabetic, that should be fine.
https://www.dietdoctor.com/low-carb/ketosis
You may find this helpful!
https://www.dietdoctor.com/why-does-my-ketone-level-fluctuate
1. Acetone- released through oral cavity.
2. Acetoacetate- released through urine.
3. Beta-hydroxybutyrate: released in blood.
The urine strips measure a different type of ketone than the blood strips hence you get different readings because theyāre completely different types. The blood ketone reading is however much accurate. Hope this helps.
Muskaan
I've done the keto diet for just a couple months for the last two years. Each time I lost what I needed to: about 15 pounds. I regained after in the winter months due to work cycles, stress, laziness, love of beer, etc.. the yo-yo effect. My GP doesn't like the keto diet (or any diet, he just says learn to be reasonable and eat a variety of foods, right good luck with that!!). But I feel very motivated when on the keto diet, and it's very effective, I find. Some psychological virtuous effect comes into play. It's always in the Spring...
Advice (from an amateur) for people with no weight loss: keep a log: not just diet, but ketone levels if you're testing, sleep duration and quality, exercise, and other notes. Make a table in a word processing program, and fill it out each day. Use colors to hilight certain key info. Also research carbs for all foods you eat, and in your log, highlight with a color those foods, even if they are really low carb (like say Macadamia nuts). a medium apple is 25g carbs, fennel is, peanuts are, etc.. without going crazy weighing all these foods, you'll see a pattern developing visually in your log (mine in on my computer), and this will really help you 'out' the carbs and get a sense of how to reduce, if needed. Also will help see if your protein is too high. The log is also a ritual which for me helps me stay motivated. While I realize I may want results too fast, I still enjoy the process and am interested in documenting all this at least part of the year.
I do 30 Km of road cycling some days, and so I can eat an apple (before) I find and still get great ketone levels. Btw, I just measured 2.8, and it's the highest I ever have had. I lost weight in the past on this diet without ever reaching that level. So, I may eat two apples today , or maybe throw a half a carrot in there for fun. Thanks and good luck to all.
Check out this article on the accuracy of each method of ketone testing. https://www.dietdoctor.com/low-carb/keto/ketone-testing-three-ways
Readings for different devices often have different scales. You may need to compare your reading to the scale for your device. If the reading is 7.9 mmol/L there may be cause for concern.
also
if you read ketones of 0.2 and above on a keto diet does that mean you are using the fat as your main source of energy/ fat adapted even if you are not in ketosis blood sugar levels above 0.5?
thank you
also
if you read ketones of 0.2 and above on a keto diet does that mean you are using the fat as your main source of energy/ fat adapted even if you are not in ketosis blood sugar levels above 0.5?
thank you
Check out this Q&A with Dr. Bret Scher. https://www.dietdoctor.com/why-does-my-ketone-level-fluctuate You may also find this guide to ketosis helpful as it discusses measuring ketones and what impacts ketone levels. https://www.dietdoctor.com/low-carb/ketosis
If you are using a blood test monitor or are on any medications for diabetes or feel unwell, please call your doctor immediately. That is well outside the range of normal ketone levels.
https://www.dietdoctor.com/low-carb/ketosis#ketosis-ketoacidosis
Anything 0.5 and higher is considered ketosis. You might try lowering your carbs to achieve a higher reading.
https://www.dietdoctor.com/low-carb/ketosis
If you are using a blood test monitor or are on any medications for diabetes or feel unwell, please call your doctor immediately. That is well outside the range of normal ketone levels.
https://www.dietdoctor.com/low-carb/ketosis#ketosis-ketoacidosis
Let me know! š
That's going to vary widely from person to person. Anything within the range of nutritional ketosis will yield the same results for weight loss:
Between 0.5-3.0 mmol/L is nutritional ketosis. This is where you see the beneficial effects on weight and metabolic health. For most people, it wonāt matter where in this range you fall
Dt1? If you mean type 1 diabetes, please work with your doctor. High ketones can be dangerous for people with type 1 diabetes.
https://www.dietdoctor.com/diabetes/type-1
From the guide above:
Values of over 3 mmol/L arenāt necessary. That is, they will achieve neither better nor worse results than being at the 0.5-3 level. Higher values can also sometimes mean that youāre not getting enough food. For type 1 diabetics, it can be caused by a severe lack of insulin, see below.
Your problem is most likely based on your counting of NET carbs only. Most doctors who specialize in years of training & research on keto diets will all tell you that this relatively new concept of net or digestible carbs is just a marketing ploy that helps many food item be marketed as āketo-safeā when they really are FAR from it.
Count ALL carbs and keep it to 20 or under and your ketone level & weight loss will surely rise. Donāt buy into this net carb b.s.!!! Another helpful option is to drink extra ketones. There are many brands out there now that make flavored drinks or drink powders that add ketones to your body. One brand that I recall off the top of my head in NAN. Good luck!
You can read through the information we have on this topic by clicking the blue hyperlinks or the circled in line notations.
thanks for any tips and advice.
Here is our top weight loss guide.
Hi Karen, it is best if you refer to the manual that comes with the tests you use. Various products will have use slightly different measures. I encourage you to read through our guide on ketosis as it provides a thorough overview of what ketosis is, various ways to measures, and important things to be aware of https://www.dietdoctor.com/low-carb/ketosis#signs-ketosis.
Here is a guide to the rest of our top tips. It can be normal to lose more some weeks than others.
https://www.dietdoctor.com/weight-loss/how-to-lose-weight
Any kind of exercise may raise blood sugar which can affect ketosis. In the long run though, that may not be as important as the other health benefits from exercise. You can read more in our guide to ketosis.
https://www.dietdoctor.com/low-carb/ketosis
Hi, Heidi! There would generally be no concern with that number. Here's more info regarding ketosis! https://www.dietdoctor.com/low-carb/ketosis