If you’re following a ketogenic diet, then your primary goal is likely to produce ketones. Instead of using sugar as fuel, your body is converting fat into ketones, which are then used as fuel. The more ketones you have in your body, the higher the chances are that your body is in the metabolic state of ketosis. When you’re in ketosis, it means you are burning fat as your body’s primary energy source.
How to Tell if You’re in Ketosis
So, you may be wondering how to know if you’re in ketosis. Well, you’re technically considered to be in nutritional ketosis when your blood ketones measure 0.5 mM/dL; and, the optimal range for maximum fat-burning is between 1.5 to 3.0 mM/dL.
While there are a few different ways to measure your state of ketosis, none are particularly reliable in assessing one’s true ketogenic state for a number of reasons:
Urine Test Strip
The most common way people test their ketone levels is through urine test strips; however, these test strips are primarily made for type 1 diabetics and only use a colour chart as a means to approximately test ketone levels. Plus, this form of testing is meant to measure the acetoacetate in your urine, which is different from, say, measuring the BHB in your blood.
Plus, while these strips test your ketone levels, there is no way to tell how well your body is using those ketones. Which, if they were being used efficiently, then the colour strip would actually be lighter, not darker. Not to mention, certain medications, Vitamin C supplements, and your level of hydration can drastically affect the outcomes of your test. For example, if you’re well hydrated, your ketone levels will show as lighter than if you’re dehydrated.
One final note on urine test strips for ketone levels, is that if you’re ingesting exogenous ketones, then the majority of these are burned in the body, so very little is expelled through urine. And, when your ketones are high, there’s not an accurate correlation between what is found in your urine versus blood.
Blood Test
A blood test for BHB is therefore considered a more accurate representation of ketone levels, because it is able to detect an actual number than, say a more subjective method such as colour. This test is quite similar to testing blood sugar. When performing a blood test, you will want your number to be in the range of 0.5-3 mmol/L for nutritional ketosis, encouraging optimal weight loss, athletic performance, and mental clarity.
However, if you’re just looking for signs that you’ve reached ketosis, you’ll be able to smell the acetone in your breath, which is hard to miss! Just don’t expect it right away, it can take upwards of 3-6 weeks to truly be in a metabolic state of ketosis.
What’s the Optimal Ketone Level for Your Ketogenic Diet?
So, you’re probably wondering where your numbers should lie, depending on your goals. As mentioned earlier, as long as your ketone levels are above 0.5 mmol/L, then you’re in nutritional ketosis, the optimal range for weight loss, improved athletic performance, and sharper mental focus. Of course, the closer you are to 3 mmol/L, the more optimal your levels are.
Now, there is a whole other level of ketosis that is considered therapeutic, where your levels should be between 3-6 mmol/L if you’re looking to treat or prevent illness, such as cancer.
And, of course, these numbers are strictly based on someone who has healthy levels of blood glucose, and not for someone who has type 2 diabetes or is pre-diabetic. These numbers are for nutritional ketosis only and should never be used if you have type 1 diabetes.
Again, these numbers are meant as a general guide and shouldn’t be obsessed over. If for some reason your numbers don’t fall within this range, it doesn’t necessarily mean that you’re doing anything wrong. However, if your numbers are more in the range of 15-20 mmol/L or higher, then you’re in danger of diabetic ketoacidosis, which is a medical emergency.
Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes and requires immediate medical attention. Simply, the body is unable to produce insulin, so sugar cannot get into the cells, so the body goes into ketone production overdrive. There is no mistaking the symptoms of DKA and you can’t confuse whether you’re in a nutritional state of ketosis or a life-threatening state of ketoacidosis. Early symptoms of DKA are dry mouth, excessive thirst, frequent urination, fatigue, nausea, vomiting, and abdominal pain, and can increase your risk of coma or death if not properly treated in time.
If you’re fat adapted, you won’t have any sugar cravings, you will have low inflammatory levels, your mood will be stable, and you will have optimal mental clarity. Alternatively, if you’re hypoglycemic (a symptom of DKA), you will have sugar cravings, chronic inflammation, you’ll be tired and irritable, and unable to concentrate.
Should I Worry about DKA?
In theory, if you have a predisposition to diabetes and you’re restricting your carbohydrate intake for nutritional reasons, then it is possible for ketoacidosis to occur, as discussed in this case study.
However, it’s important to understand, that unless you are diabetic, it is virtually impossible to reach a state of DKA through diet alone. For example, a healthy person could technically water fast for three weeks and still have a ketone level less than 20 mmol/L.
If you consider our ancestors who had to endure periods of prolonged starvation, ketosis is what helped them to survive. So, I would suggest placing more focus on your energy levels and mental state, than a colour on a test strip, or number on a blood test. Unless you’re experiencing early symptoms of DKA, in which you should seek medical attention for, then take solace in knowing that you’re in a metabolic state of ketosis and reap all the benefits!