What are the Ideal Ketone Levels For Ketosis?

The ketogenic diet was originally created and used as a treatment for those with epilepsy and was first introduced in the 1920s for those who'd respond to traditional anti-epileptic drugs.

Because the ketogenic diet causes the body to run on fat as its primary fuel source instead of glucose (a state called ketosis), it's been used successfully to reduce or eliminate seizures by lowering excitability in the brain.

Over the years, keto has become a popular diet for weight loss and individuals with diabetes. Mainstream media, along with the fitness industry, often promote this diet to accelerate weight loss, especially for people with poor blood glucose levels.

To determine if you've achieved ketosis, you'll want to monitor your ketone levels and keep them in an optimal state. In this post, we'll cover what the ideal ketone levels are and how to optimize them to meet your health goals.

What are Ketones?

On a basic level, ketones (often known as ketone bodies) are the indicators that show whether you're in ketosis or not. Your liver produces these chemicals as your body enters the ketosis state.

In a typical diet encompassing all macronutrient groups, carbohydrates are metabolized into glucose post-meal consumption, serving as a source of energy in the body. Conversely, by decreasing carbohydrate intake on the ketogenic diet, the body adjusts its energy generation processes.

Instead of using glucose to make ATP (the energy molecule), your body breaks down fats into fatty acids. These fatty acids undergo a process called beta-oxidation, in which they are then converted into a molecule called acetyl CoA.

From here, two additional things happen: this molecule is used to produce ketone bodies and it's also used to produce ATP. That's why ketones are almost always used as an indicator of whether an individual is in ketosis or not.

What Level of Ketones Indicates Ketosis?

Nutritional ketosis, or restricting carbohydrate intake to achieve ketosis, is marked by a certain level of ketones in the blood.

Research suggests that the standard level of ketones that indicates that a person has achieved ketosis is a hallmark value of 0.5–3 mmol/L blood ketones.

It's important to note that ketone levels can fluctuate throughout the day. If you've noticed this or are worried about this problem when you begin your keto journey, discuss the issue with your nutritionist or dietitian.

What are Ideal Ketone Levels?

The ideal ketone level may vary depending on your goals. While nutritional ketosis is a normal physiological response to low carbohydrate intake, another state known as ketoacidosis is dangerous and can result in a coma or death.

According to the Global Diabetes Community, nutritional ketosis is achieved when ketone levels hit 0.5. Light nutritional ketosis is said to be achieved when ketone levels are between 0.5 to 1.5 mmol/L, and the ideal ketone levels for weight loss are between 1.5 to 3 mmol/L.

One study found these values to be helpful for seizure control as well. The authors found that 82 percent of those with ketone levels between 1.6 and 3 mmol/L remained seizure-free, suggesting these values can provide the greatest health benefits.

Ketoacidosis

It's important to note that nutritional ketosis is very different from the type of ketoacidosis seen in type 1 diabetes. Ketoacidosis typically shows up with high levels of ketones in the blood, whereas in nutritional ketosis there are relatively lower levels of ketones in the blood.

This is important to recognize because many individuals focus on increasing their ketone levels to achieve nutritional ketosis. While the keto diet can help individuals with diabetes better control their blood sugar levels, having too high of ketones in the blood is not ideal and can lead to other complications.

Ways to Reach Optimal Ketone Levels 

Now that we understand the difference between nutritional ketosis and ketoacidosis, what ketones are, and why they are a key indicator of the state of ketosis, here are some tips to help you get those ideal ketone levels.

There are various approaches, from nutrition to lifestyle hacks, that can help you reach ketosis. If you've already started your ketogenic diet and have tried the common methods, you may benefit more from talking to a nutritionist about tweaking and optimizing your current approach.

Here are some of the most common and effective strategies to help you get to optimal ketone levels.

Restrict Your Carb Intake

The ketogenic diet is characterized by a very low carbohydrate intake. The ranges can vary, but in general, experts recommend that 70 to 80 percent of the calories you consume come from fat sources (no restrictions on what type of fat), 10 to 20 percent from protein sources, and 5 to 10 percent from carbohydrate sources.

In general, this means you can eat about 20 to 50 grams of carbs daily on the keto diet, although many opt to keep that number under 20 to achieve deeper ketosis. If you're new to this low-carbohydrate diet, it may be helpful to measure your current carbohydrate intake using a diet tracking app to determine whether your food intake falls between 20–50 grams.

Remember that everybody is different, and your carbohydrate range may vary from someone else on the keto diet to maintain ketosis. You may want to play around with the <20 or 20-50 gram range to find the specific number to help you reach your health goal.

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Consider Intermittent Fasting 

Another way to put the body into ketosis is to employ intermittent fasting, which works by causing the body to adapt to burning fat for fuel. This method involves a short period of time in which you can eat, which is called eating window, followed by a fast for a longer period of time.

There are different ways to approach intermittent fasting and the eating versus fasting windows. A standard split is called the 12/12, in which you can eat for 12 hours and fast for the other 12 hours.

Another common practice is known as the 16/8 split, in which you eat for eight hours and fast for 16.

You may want to extend your fasting window to help your body go deeper into ketosis. For example, if you're fasting for 12 hours, try extending that to 14 hours. Many people opt to skip breakfast as it overlaps with their fasting window and choose to have their first meal later in the day.

Before implementing this practice, work with your nutritionist to find an optimal fasting window that works with your routine and that you feel best with. You may also want to discuss how to introduce food back into your system after a fast, as your body reacts differently to food after a “starvation period."

Exercise More 

There's some evidence supporting the idea that exercise can increase ketone production. If you haven’t been successful in reaching ketosis by restricting your carbohydrate intake, practicing intermittent fasting, or logging meals to identify potential food culprits, exercise may be helpful for you.

Endurance training such as biking, swimming, and running may be especially beneficial to help you increase ketone levels. You can also try incorporating a variety of different exercises, such as weight training, cardio, and increasing your daily physical activity. 

How Does Exercise Affect Ketone Levels? 

So, how exactly does exercise affect ketone levels? The answer is still a little unclear.

Exercise could temporarily reduce ketones or halt ketogenesis, as the body is going to use the glucose as energy instead. This tends to be a temporary effect as the body uses immediate energy for your workout, and ketones usually go back to normal ranges a few hours after exercise.

One study demonstrated that exercise does appear to increase blood ketone production, but that increase doesn't result in greater beta-oxidation. This suggests that while exercise increases ketone levels, it's not a long-term or effective solution to moving the body into ketosis and maintaining that state.

Of course, this has a lot of nuance to it. As nutritionist Amanda Donahue, MS, RD, CD, explains, “Ketones can increase due to utilization rate at lower intensities, but once the intensity increases, we see the energy utilization shift to glucose. Either way, increased exercise overall still helps to increase getting into ketosis by using up carb stores, and if building muscle, increasing tolerability to carbs.”

Is the Keto Diet Right for You?

While many people have found success with the ketogenic diet, it's not for everyone. It can be a challenging and restrictive way of eating, especially for people with diabetes or other health conditions, such as cardiovascular diseases, kidney disease, and liver disease, that require careful monitoring of their blood glucose levels.

For people with certain neurological disorders, such as Alzheimer's disease, multiple sclerosis, and Parkinson's disease, the keto diet has shown promise in managing symptoms and improving overall health. By reducing inflammation and oxidative stress in the brain, the keto diet may help contribute to slowing down the progression of these neurological disorders and could also help promote better cognitive function.

Individuals with mental health problems, such as major depression, anxiety, bipolar disorder, and schizophrenia, may also benefit from following a ketogenic diet. Research has shown that the keto diet can improve symptoms and outcomes in these patients by reducing inflammation, stabilizing mood, and increasing brain-derived neurotrophic factor (BDNF) levels. By following the diet, individuals tend to lower their antidepressant and antipsychotic medication use, leading to fewer side effects and better quality of life.

With less sugar in the gut, the keto diet can have a positive impact on gut health. By reducing inflammation and restoring balance to gut bacteria, it can help with gastrointestinal disorders, such as inflammatory bowel disease (IBD), Crohn's disease, ulcerative colitis, and irritable bowel syndrome (IBS). Research has also shown that the keto diet could be effective in managing symptoms of leaky gut syndrome, a condition caused by increased intestinal permeability.

Moreover, the keto diet has been linked to improved cardiovascular health. By reducing inflammation and improving blood lipid levels, it may lower the risk of heart disease, stroke, and type 2 diabetes. The diet may also increase levels of high-density lipoprotein (HDL) cholesterol, known as the "good" cholesterol, and decrease levels of low-density lipoprotein (LDL) cholesterol, known as the "bad" cholesterol. This can help improve overall heart health and reduce the risk of cardiovascular events.

People with type 2 diabetes also find benefits from following the keto diet. Studies find that when these individuals use fat for energy when they're on this low-carb diet, they benefit from better blood sugar control and insulin sensitivity. This is because the keto diet promotes weight loss, which in turn can improve glycemic control and reduce the need for diabetes medication.

Furthermore, research has shown that the keto diet may be an effective treatment for metabolic syndrome, a cluster of conditions including obesity, high blood pressure, insulin resistance, and high cholesterol levels. By reducing overall body fat and improving metabolic markers, the keto diet can help manage or even reverse this condition.

Before jumping into a ketogenic diet, always consult with your healthcare provider and make sure it's the right choice for you. They can help you determine if any adjustments need to be made for your specific needs, such as adjusting medication dosages or monitoring ketone levels more closely.

Side Effects of Keto Diet

Another aspect to consider before starting this restrictive diet is the potential side effects. Some common side effects many people experience when they first start the diet include:

• Headaches
• Dizziness
• Brain fog
• Fatigue
• Nausea
• Digestive issues
• Muscle cramps
• Bad breath
• Body odor
• Strong-smelling urine
• Unpleasant odors from intimate areas (some people refer it as jock stink)
• Frequent urination,
• Cold sweat
• Rapid weight loss

These side effects are often referred to as the "keto flu" and typically last for a few days to a couple of weeks as your body adjusts to using fat as its primary source of energy. Staying hydrated, consuming enough electrolytes, and getting adequate rest can help alleviate these symptoms.

How to Measure Ketone Levels

There are a couple of different ways you can measure your ketone levels. The first, which we already touched on, is testing your blood (or serum) ketone levels using a ketone blood test. The second is testing urine ketone levels using a urine ketone stick test.

The ketone blood test involves drawing blood from a vein, usually from inside the elbow or back of the hand. The blood sample is then tested for ketone levels.

The urine ketone stick test involves collecting a urine sample and using a testing strip to measure your ketone levels. Your doctor will be able to decipher the results for you, or if using a self-test kit, you'll want to follow the instructions and color key to determine what the results mean.

Advantages of Each Test

The advantages of using a ketone blood test include:

• Measures current blood ketone levels, giving a more accurate view of the state of ketosis.
• Fast, immediate measurement.
• Greater sensitivity and specificity (especially for detecting diabetic ketoacidosis).
• Quick results allow for timely changes to the management plan as needed.

The advantages of using a urine ketone stick test include:

• Painless and relatively cheap.
• Readings can be read off the bottle.
• No technical skill is required for this equipment.

Disadvantages of Each Test

The disadvantages of using a ketone blood test include:

• Potentially painful.
• Need staff and equipment to draw blood and get results.
• The meter may be inaccurate at readings if readings are outside the range it's designed for.
• Other nutrients, such as vitamin C, may interfere with results.

How Often Should You Measure Ketone Levels?

As you start the keto diet, you may want to monitor your ketone levels more frequently to determine if you're entering ketosis.

For consistency, it's best to monitor your levels first thing in the morning, or at the same time each day. Once you have reached this state, you may be able to monitor your ketone levels less frequently.

It's best to discuss with your nutritionist what frequency is best for you and your unique needs. Some may want to check their ketone levels every day, while for others, checking every couple of weeks may be better.