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estimating blood ketone levels from blood glucose readings

Answered on August 19, 2014
Created August 13, 2013 at 7:22 PM

Ok so the doctor suspects my aunt has a lymphoma, which is a type of cancer.

I would like her to get into a state of nutritional ketosis so she can get rid of it through autophagy and by starving the cancerous cells of sugar. I had planned to make her measure her blood ketone levels so I can monitor her progress and modify her diet when necessary, especially because I won't be seeing her everyday and I need a way to make sure she's doing the diet right.

Unfortunately I'm on a low budget, and I can't afford too many ketone test strips (she will be using Precision Xtra). The BG strips, on the other hand, are a lot cheaper.

So I had this idea of only measuring her blood glucose levels. If the blood glucose level gets below normal range, that means ketone bodies are doing the job of supplying the rest of her energy, right? Then the fasting ketone level must be somehow inversely proportional to the fasting sugar level. For example if the glucose meter reads 50mg I can be sure she's in ketosis(if she doesn't show symptoms of hypoglycemia that is).

At the same time, I would like to get the actual numbers for ketones. Our plan is to get her to around at least 2.0 mmol consistently. So this was a lengthy post, here's my question: Is there a formula to estimate ketone levels from just knowing the blood glucose level?

What were your own BK and BG levels both at one given time while on keto?

edit/

Thank you for those who answered so far :)

Yes, I am aware that ketosis is not the solution for all diseases and all types of cancer. But I have seen observational studies suggesting that fasting for 140 hours before and after a chemotherapy diminishes its side effects such a nausea and fatigue, and can also raise the chance of survival. Keto is kind of a "fake starvation" so I thought it would do the same. My aunt is just not fat enough to be starving herself for real.

Also, it seems to me that the common things between ketogenic diet, exercise, lower calorie intake, starvation and natural anti-cancer components such as resveratrol or green tea extract, is that they all help catabolizing fat and they all "switch on" autophagy. And it also happens that they all help to fight cancer. That was enough to draw my interest. Maybe there are only anecdotal evidences for the moment regarding ketosis and cancer, I just want all the chances on our side. Surely it doesn't do any harm?

3491e51730101b18724dc57c86601173

(8395)

on March 15, 2014
at 04:16 PM

I ordered ketone strips from this guy and they never arrived. I had to open a dispute with PayPal and eventually got my money back. To be fair it looks like it may have been a shipping issue. The tracking number I was given didn't work at first. Later it showed that the order was processed with the USPS in Los Angeles, but never made it to my door.

The seller made no effort to respond to me when I emailed him about the non-delivery and was slow to respond to PayPal as well. The process of getting my money refunded took quite a while.

Buyer Beware.

A7b483a18f077fc926c9795a1f1aa9ca

on March 14, 2014
at 05:43 PM

OK now I'm reasonably sure you have skin in the game for that site, since your only two posts are promoting it, but for anyone else out there reading this, beware the shipping costs at ketosistools.com - if you order 10 packs, it's not going to be worth it.

A 50-pack is $75 + $15 shipping (yup - takes 7-10 days to ship too), so you'd end up paying $1.89 per strip. You can get it down to $1.75ish by buying multiple 50-packs (first one is $15 to ship, additional ones $5 ea.)

Still a good deal, assuming they're reputable and you actually get the strips and they're not expired.

5ccb98f6ae42ce87e206cf3f6a86039f

(11581)

on August 14, 2013
at 11:35 PM

Typically sub 50 gms of carbs per day will be ketogenic. To be extra sure go sub 30 gms per day. Ketogenic diet is not magic though. Don't count on it as a cure.

Ffb647bad862697f84b08c513807ac16

(10)

on August 14, 2013
at 05:12 AM

woups I meant negative correlation between BK and BG, with some sort of coefficient in the formula of course because ketone bodies and glucose don't produce the same amount of ATP.. I realized that it would be difficult to calculate this because different ketone bodies also produce different quantity of ATP. Unless the AcAc/3HB/acetone ratio is constant (and those are only the 3 main ketone bodies) there wouldn't be much use in trying... It would be very fun to figure these things out though.

Ffb647bad862697f84b08c513807ac16

(10)

on August 14, 2013
at 04:19 AM

thanks for the input. I'm curious though what you think of my theory. Wouldn't that make sense if BG were inversely proportional to BK? Have you read anything that suggests there is no correlation? I'm not confident on the whole fruity smell thing, because when I do keto, I never notice any change in smell. I know I am in ketosis when I feel more energy.

D33a8d5f095a8532ddf7a0d6c27bfe63

(578)

on August 13, 2013
at 11:20 PM

You're trying to see if there is a relationship between hypoglycemia and ketosis. The link is tenuous and isn't worth exploring. It's better to learn to recognize ketosis from the fruity smell of her breath and urine. Or keep a watch on what's she's eating. She'll probably be ketogenic at 50g carbs or less or less than 500 calores combined of carbs and protein, especially if she's active. But you need to question the whole thesis of curing cancer via ketosis. Doesn't work in all cases. You might wanna explore other options.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on August 13, 2013
at 11:15 PM

Those are glucose strips not ketone strips.

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5 Answers

2
0f44d81f247518d6fc2de0403ff9a68a

on August 28, 2013
at 05:20 AM

Let me immediately come to the point: There is absolutely no way of calculating or even estimating the blood ketone level based on the blood glucose level.

The only conclusions you can draw is that if you have a very high blood glucose level (way above normal), you probably have a very low blood ketone level and if you have an extremely low blood glucose level (way below normal) without fainting or being in a coma, then you have enough ketones and can also utilize them.

Other then that, there really isn't anything you can say about the connection. There isn't - unfortunately - some type of simple mathematical connection.

Let me give you some examples of my own measurements (although I have to note that I didn't measure blood glucose that often) to demonstrate how relatively independent both values are. The corresponding ketone and glucose levels were measured only about 1 minute apart. Almost all measurements are morning fasting levels:

(Note: all ketone levels are mmol/l, all glucose levels are mg/dl)

  • ketones: 1.7, glucose: 80
    • you can see: pretty good ketone level and relatively low glucose level
  • ketones: 2.3, glucose: 82
    • here you see a 0.6 increase in ketones, but glucose almost didn't change
  • ketones: 3.0, glucose: 72
    • here you might suspect that ketones increased because blood sugar got lower; but look at the next measurement
  • ketones: 2.9, glucose: 89
    • almost identical ketone levels, despite glucose being higher by 17; or look at the next one
    • plus: compare that to the first level: ketones are higher by 1.2, despite my glucose also being higher by 9
  • ketones: 2.6, glucose: 96 (this is not fasted, but about 2 hours after a meal)
    • Ketones are higher by 0.9 compared to the first measurement, despite glucose also being higher by 16.

You can see two things here:

  1. No real correlation between ketone and glucose levels.
  2. My blood sugar levels are not below normal. My morning fasting levels average to a little over 80 mg/dl and are always in the normal range of 70-100 mg/dl. Blood glucose is tightly regulated and it won't just drop to 50 if you get into ketosis.

You can see, that measuring blood glucose is not a substitute for measuring blood ketones. You don't necessarily need to measure every day, though. If the diet is consistent, measuring once or twice a week is ok. It's really only the beginning where you are encouraged to measure daily, to see how the values "behave".

I personally did my first measurement 1 week after starting ketosis and then measured it twice a week (I currently measure daily, but only because I am experimenting with diet and supplements). You might want to look for ketone strips outside of the U.S. (if you live in the U.S., that is), because the strips are way too expensive there. Prices are supposed to be $6 per strip in the U.S.; Australia seems to be cheapest with under $1 and I pay about 1.40 EUR (under $2) per strip. That can make a huge difference.

You might want to buy the book "The Art & Science of Low Carbohydrate Performance" by Stephen Phinney and Jeff Volek. It contains valuable information about ketosis.

Some notes on ketosis:

  • For a women, try about 60g of protein (you can change it later, if you notice it's too much or if you might get away with more)
  • Go at about 20g-30g of carbs a day (You actually don't really have to count carbs, if you just avoid foods that contain significant amounts of it. If you eat meat, fish, eggs, fats, lettuce and low-carb vegetables, then counting carbs should not be necessary, because you pretty much can't get too much of them. Just look at carbs if you have problems with your ketone levels
  • Avoid most dairy (especially milk and maybe even yogurt). Yogurt technically is ok, but I can tell you from experience that you need to be careful with it and only use small amounts. (And test ketone levels to measure the effect it has on them)
  • Use liberal amounts of coconut oil and/or MCT oil to support ketosis
  • Look into Lysine and BCAAs as supplements, which can support a ketogenic state.

1
32f5749fa6cf7adbeb0b0b031ba82b46

(41747)

on August 13, 2013
at 09:12 PM

Be forewarned: Ketosis is not a cure-all for cancer.

0
705d48a829629fe36c8044445f6c3341

on November 18, 2013
at 04:07 AM

@Alice 8 If you're after affordable blood Ketone strips - I'd give www.ketosistools.com a go - they've got the cheapest I've seen online ... I buy from them all the time...

Good luck with everything and please keep us updated how you go.. .

3491e51730101b18724dc57c86601173

(8395)

on March 15, 2014
at 04:16 PM

I ordered ketone strips from this guy and they never arrived. I had to open a dispute with PayPal and eventually got my money back. To be fair it looks like it may have been a shipping issue. The tracking number I was given didn't work at first. Later it showed that the order was processed with the USPS in Los Angeles, but never made it to my door.

The seller made no effort to respond to me when I emailed him about the non-delivery and was slow to respond to PayPal as well. The process of getting my money refunded took quite a while.

Buyer Beware.

A7b483a18f077fc926c9795a1f1aa9ca

on March 14, 2014
at 05:43 PM

OK now I'm reasonably sure you have skin in the game for that site, since your only two posts are promoting it, but for anyone else out there reading this, beware the shipping costs at ketosistools.com - if you order 10 packs, it's not going to be worth it.

A 50-pack is $75 + $15 shipping (yup - takes 7-10 days to ship too), so you'd end up paying $1.89 per strip. You can get it down to $1.75ish by buying multiple 50-packs (first one is $15 to ship, additional ones $5 ea.)

Still a good deal, assuming they're reputable and you actually get the strips and they're not expired.

0
887a9c6c0ee243584548f02d45c439a6

(415)

on August 28, 2013
at 04:59 AM

Sorry to disappoint you, but blood glucose won't be lower in long term ketosis. From what I've seen, it might be even on the high end of normal range.

Mine certailny was (100 mg/dl after three months in ketosis).

0
718fd304d7abab150730638bf2be5153

(184)

on August 13, 2013
at 09:23 PM

You can get 100 strips for $42 here : http://www.amazon.com/Precision-Xtra-Blood-Glucose-Strips/dp/B0017JKD6Y/ref=pd_bxgy_hpc_text_z

Best wishes for your aunt.

3ce6a0d24be025e2f2af534545bdd1d7

(26217)

on August 13, 2013
at 11:15 PM

Those are glucose strips not ketone strips.

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