Suggestions on how to achieve optimal ketosis?

June 1 2019 by in Keto, Ketosis, Q&A, Weight loss

Do you have suggestions on how to achieve optimal ketosis? Can you follow a keto diet without a gallbladder? Effects of alcohol? And, not losing nor gaining weight, what can you do?

Get the answers to these and other questions in this week’s Q&A with me:

Why am I not achieving optimum ketosis?

I am being very strict about carb intake (20 grams net carbs, or less). I am using a tracking app – Carb Manager. I have been reading articles here and have realized that I may have been eating too many protein grams, and have endeavored to eat less than 60 protein grams. It’s often hard for me to achieve 121 grams of fat, which my tracking app tells me I should eat given my height, weight, etc. But, I get close.

I bought a ketone meter (Precision). The best I have registered is 0.04 for ketones – most often it registers 0.03. What am I doing wrong? I am female, 68 years old. I feel great, am losing weight (about 22 pounds in three months, with a goal to lose 50 more). I’ve been struggling with weight for 30 years, and only wish I had known about ketogenic eating before this (I had done Weight Watchers, Atkins, and many others before this).

I am totally sugar free and no refined carbs of any kind. I am fortunate to not have had any other health issues, so far. All my lab numbers are normal. I am being very strict! I want to get to 1.5 mmol minimum!? Suggestions?

Jenny

Hi Jenny!

I’d suggest not worrying about the ketone numbers too much. As long as the diet is successful for you in other ways, all is fine. I also would not recommend eating more fat than you feel you want, that’s just going to slow down your weight loss. Trust your body at least as much as your tracking app, probably more. ;)

Best,
Andreas Eenfeldt

Keto without a gallbladder

Hi,

I am new to this and I had my gallbladder out several years ago. Is there anything I should avoid?

Carmen

In general, keto seems to work well for most people even without a gallbladder. If you get stomach upset or loose stools you may want to avoid eating larger portions of fat at once.

Best,
Andreas Eenfeldt

Alcohol effects

There seems to be much disinformation concerning alcohol. Keto books all state that it is full of calories. Can I suggest that this is totally misleading. Alcohol has a totally different metabolic pathway via acetaldehyde and acetic acid. With the exception of beer and cider (full of carbs), alcoholic drinks have little effect on calories and weight. Just look at Wikipedia on this subject. A vast number of studies, including those on 80,000 and 140,000 subjects say: “The relationship between alcohol and weight is the subject of inconclusive studies. In some, there is a small decrease in weight among women who consume alcohol.” Why are you so naive on this subject, please?

Stephen May

Observational studies can’t really be trusted either way unless the effect is huge. So I’d disregard those.

Alcohol does contain calories and thus it can affect weight, though certainly more so with drinks containing carbs, like beer.

Low-carb alcohol – the best and the worst drinks
Best,
Andreas Eenfeldt

Not losing and not gaining

Hi Dr. E ☺️
I am not losing or gaining. I feel well, but am discouraged. I am not very hungry, which is good. I do drink three cups of coffee a day with heavy cream…about 1.5 tablespoons each. I take an antidepressant, cholesterol med, ibuprofen and inhaler for my asthma. I have a stressful job. I am discouraged.

Gloria

If you’re not hungry when you’re drinking your coffee, I’d definitely recommend drinking it black or with just a little milk. That could help quite a bit with weight loss.

More ideas here.

Best,
Andreas Eenfeldt

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15 comments

1
Melissa Knue
June 1 2019
I drink Gin with lemon or lime and add a touch of honey or Blue Agave. Only 69 a shot glass. Not Bad. I'm still losing fat and weight. Enjoy.

Reply: #5
2
Suzanne
June 1 2019
very discouraged by the answers to some of the questions. no real help offered . wow

Reply: #4
3
JoAnn
June 1 2019
lots of flavored vodkas with flavored water (w/o) any sweeteners are awesome... also Presecco is my go to - one of the lowest carb/ cal counts
4
Reply to comment #2 by Suzanne
Kristin Parker Team Diet Doctor
June 2 2019

very discouraged by the answers to some of the questions. no real help offered . wow

Hi Suzanne, this article is only 10 hours old and I don't see any questions here. I'm not sure what you're referring to?
5
Reply to comment #1 by Melissa Knue
Kristin Parker Team Diet Doctor
June 2 2019

I drink Gin with lemon or lime and add a touch of honey or Blue Agave. Only 69 a shot glass. Not Bad. I'm still losing fat and weight. Enjoy.

If you stall or aren't seeing the progress you would like, you may want to consider dropping the honey/agave as they are not low carb friendly.
6
Kristine Hartford
June 2 2019
First...thank you to the Diet Dr team ..I'm not a member but I have gotten alot of *verifiable* info here that has helped my understanding & success transitioning & maintaining a Keto lifestyle. I've had many conversations with my Dr about different topics here.

I've been eating keto for a year and a half, I've got severe nerve damage in the base of my spine and have been dealing with chronic pain for about a decade now, one of the medications I take came up in conversation and I'd like to know if Gabapentin (Neuro in) has any effect on ketosis. If so is there anything I can do short of not taking it?

Thanks!
Kristine
7
Phil Thompson
June 2 2019
I don't recall two decimal places on a ketone meter. Are you sure?
8
Karen
June 2 2019
I hope you get answers to your questions. I am just starting the keto diet and have chronic, chronic pain.(Spine knees,etc since 1992). I am on oxycodone, gabapentin, tinizidine plus many other prescription medications and it is difficult to have enough stamina tp cook. I am setting my goal for 70 lb. Weight loss so i will need lots of directions and encouragement.
Kind regards,
Karen
9
Bart
June 3 2019
Did you seriously suggest drinking milk?? SMH.
10
Kristin
June 3 2019
Yes you can get low carb alcohol, but I rarely touch it for 2 reasons. I have fatty liver, and from what I've read, it's not wise to drink alcohol when you have fatty liver as it impacts the healing process. And then there's the fact that if I drink any alcohol at all on low carb, it all goes to my head immediately, it's ridiculous, 1 glass of wine and I feel drunk. My understanding is that alcohol is processed similarly in our liver to how sugar is, and when you don't consumer sugar and carbs, there is no delay in your body processing the alcohol.
And a tiny splash of milk won't affect weight, a coffee made predominantly on milk will build your carbs quickly, but it's 4%, so a small splash of milk is hardly any carbs. I personally never have it in the house, and use cream at home, but I'll take milk when I'm out and about if there is no other choice, which is rare. I would love to enjoy the taste of coffee black, but I just don't :(.
11
Amie
June 10 2019
You can train yourself to enjoy black coffee. Start with very weak instant coffee at home.
12
Badr
June 28 2019
I want to ask about bulletproof coffee where to get it ???

Reply: #13
13
Reply to comment #12 by Badr
Kristin Parker Team Diet Doctor
June 28 2019

I want to ask about bulletproof coffee where to get it ???

We have a recipe!
https://www.dietdoctor.com/recipes/bulletproof-coffee
14
Criste
April 11
I have been following the Keto diet for 2 months and can not figure out what I a doing wrong. I do an 80/15/5 split between fats, protein, carbs on an 1100-1200 calorie per day diet. I have only lost about 5 lbs total and I DO NOT cheat, I TRACK EVERYTHING! I have used urine sticks, a breathalyzer reader, and a blood reader to track ketosis and I simply can not enter into it. The closest I came to showing signs was after fasting for 48 hours. The minute I consumed food the readings were gone. What on earth am I doing wrong, I am 47, very healthy aside from the extra 30 lbs and have no health issues.

Reply: #15
15
Reply to comment #14 by Criste
Crystal Pullen Team Diet Doctor
April 12

I have been following the Keto diet for 2 months and can not figure out what I a doing wrong. I do an 80/15/5 split between fats, protein, carbs on an 1100-1200 calorie per day diet. I have only lost about 5 lbs total and I DO NOT cheat, I TRACK EVERYTHING! I have used urine sticks, a breathalyzer reader, and a blood reader to track ketosis and I simply can not enter into it. The closest I came to showing signs was after fasting for 48 hours. The minute I consumed food the readings were gone. What on earth am I doing wrong, I am 47, very healthy aside from the extra 30 lbs and have no health issues.

Check out our How to Lose Weight Guide: https://www.dietdoctor.com/how-to-lose-weight You may also want to prioritize protein and add fat for flavor while continuing to keep carbs very low.

Suggestions on how to achieve optimal ketosis?

Why am I not achieving optimum ketosis?

Keto without a gallbladder

Alcohol effects

Not losing and not gaining

More

More questions and answers

Q&A

Videos with Dr. Eenfeldt

More with low-carb doctors

15 comments

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