Reasons You May Not Be Producing Adequate Ketones [Part 1]

Some people are in a big rush to begin producing ketones. If you try to hurry this process, don’t be surprised if you struggle. The “I want it now” attitude leads to an increase in stress, and that’s a surefire way to kill your ketones.

– Stephanie Person


Ever since I started writing on my blog about my nutritional ketosis n=1 experiment, I’ve received quite a few emails from people who are frustrated and concerned about their inability to produce adequate ketones while eating what they think is a good low-carb, moderate-protein, high-fat diet. Here’s just one example of the comments I’ve received:

I’m using the blood ketone meter you recommended to check for ketosis. I eat under 50 grams of carbs most days and I’d be quite surprised if I went over 100 grams of carbs on a “bad” day. I’ve been eating this way for about six to eight months. Whenever I test my ketones at night, around 7 p.m. or so, I only get readings of 0.2 to 0.4 millimolar, below the level of being in nutritional ketosis. I desperately want to experience all the great benefits that ketones have to offer me, but I suspect I need to be tweaking something in my routine to make more progress. Can you help me figure this out?

I absolutely can, and that’s exactly what this chapter is all about.

Perhaps, like this blog reader, your attempt to get into a state of nutritional ketosis has been unsuccessful. How exasperating is that? It can seem like no matter how hard you try to increase your ketone levels, they’re just not budging one bit. What in the world is going on, and what can be done to fix this?

Below are ten reasons why you may not be producing adequate ketones, along with some practical solutions to help you reap all the great health benefits of a low-carb, high-fat diet.

1. You’re automatically assuming your low-carb diet is ketogenic.


Most of the concerns I see with low-carb, high-fat, ketogenic diets are based on flawed scientific studies that claim to show low-carb diets are harmful. These studies are generally either done for a very short period of time or have the “low-carb” group consuming upwards of 150 grams of carbs a day along with lean meats—this is perhaps lower-carb, but nowhere near ketogenic.

– Maria Emmerich


In the example above, my reader said that he eats under 50 grams of carbohydrates most of the time, though occasionally he eats more. That’s a low-carb diet, but perhaps he is one of those people who is so sensitive to carbohydrates that he needs to lower them even more. And because he is already sensitive to carbohydrates, it stands to reason protein in excess could be an issue for him because of gluconeogenesis.

This is why it’s so important to find your personal carb tolerance level and your individual protein threshold and to eat saturated and monounsaturated fats to satiety. That really is the key to producing ketones and enjoying the benefits they can provide to you.

Interestingly, my blog reader from the example above would never have known he wasn’t in ketosis if he hadn’t been testing his ketones—which brings me to my next point.

2. You’re not testing for ketones.


When someone tells me that they have tried the ketogenic diet and “it didn’t work,” they usually haven’t attempted to measure their ketones and aren’t really in ketosis. It’s important to follow this diet for at least four to six weeks to evaluate it fairly.

– Dr. Dominic D’Agostino


This is perhaps the number-one mistake made by people starting a low-carb, high-fat diet. Whenever I receive an email from a blog reader who is flabbergasted that they’re not experiencing the benefits of ketosis, one of the first things I ask is whether or not they are testing for the presence of ketones in their body.

Many of them respond, “I just thought eating low-carb would put me in ketosis.” If that were true, then nobody would ever struggle with switching over to a low-carb, high-fat lifestyle. As we shared in chapter 8, the only way to know absolutely sure that you are producing ketones is to test, test, test. Otherwise, it’s merely a guessing game.

3. You’re still measuring for ketones in the urine, not blood or breath.


We’ve talked about this before a few times, but it’s such a critical point that bears repeating. Urine ketone testing can be helpful in the very beginning of your foray into nutritional ketosis. But here’s what happens: The testing strip turns pink the first couple days, then it may even turn purple for a few days, indicating increased levels of the ketone body acetoacetate. However, after about a week or two of being very faithful to your low-carb, high-fat diet, your urine ketones may all but disappear, making you wonder what happened and what you did wrong.

Actually, you’ve done something very right: you’ve become fully keto-adapted. Congratulations! But then why did the testing strips stop showing the presence of ketones?

The ketone body acetoacetate, which was causing your urine ketone testing strips to change color for a little while, eventually was converted into the ketone body beta-hydroxybutyrate, which is present in the blood and is your brain’s and body’s preferred fuel source when it is running on ketones. This makes it look like your ketones are disappearing when in fact you are running quite efficiently on ketones. You’ve reached low-carb nirvana!

Switching from urine ketone testing to blood or breath (which contains the ketone body acetone, whose levels correlate quite well with the levels of the ketone body beta-hydroxybutyrate in the blood) will prevent you from becoming needlessly concerned about why you’re not in ketosis.

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