Ketosis: What is the ideal blood ketone level for weight loss?

Ketosis: What is the ideal blood ketone level for weight loss?

Should you be chasing down high ketone levels
in order to optimize weight loss? Is there a blood ketone level sweet spot which will
maximize your fat burning? If so, what is it? Let’s find out. Hey Carbdodgers, my name
is Dr Dan Mags. Thanks for visiting my channel where I help people achieve long term sustainable
weight loss through low carb real food nutrition. I struggled with my weight pretty much my
entire life back until 2016 when I went from being officially obese to being a normal way
and just six months and I’ve maintained it ever since. I love to be your guide and show
you how to do the same. I release new videos here every Tuesday, so I’d love it if you’d
subscribe to my channel, hit that bell to get notified whenever I release a new video.
So, when people discover the power of Ketosis for weight loss and it is awesome, it can
be pretty normal to think if some ketones are good, then more ketones must be better.
And so, there’s this idea that you can find it optimal ketone level that will help you
lose weight at an optimal rate, but is this true and if so, what is that level?
So many so called Keto experts would have you believe that you should be aiming for
high blood ketone levels simply because that means that you’re burning more fat and that
will speed up somehow weight loss or optimize your weight loss and you may well have been
advised to cut back on the protein and increase the amount of fat you’re supplementing with
in order to get high ketone levels. As we’ll see in this video, that advice will get you
higher ketone levels, but is it really something you should be aiming for? I’m going to argue
that it doesn’t actually make any sense and in fact it may actually be detrimental. Now,
I’ve always been keen to experiment on myself and this graph shows my lean muscle mass.
When I tried to stay in a high level of ketosis for a six-week period, I lost about five pounds
of lean muscle in six weeks. Not Ideal. Definitely something you don’t want to do. Now, there’s
definitely different groups of people who may benefit from running pretty high levels
of ketones, so just therapeutic diets for epilepsy, certain cancers, certain neurological
disorders. You’ll also find that certain athletes prepare, prefer to run higher levels of ketones
relating to their needs for their sport and there’s also some cognitive benefits to higher
levels of Ketones, but there is also one group of people who definitely shouldn’t be chasing
high ketone levels and that’s type one diabetics. Now I don’t want to go into why this is here
on this video because it will take too long, but if you want to find out more about that,
then check the blog post that accompanies this video.
You’ll find the link in the description below this post that we’re focusing on today that
most people get interested in Ketosis, fat loss. Many of the websites and YouTube channels
promoting ketogenic diets will tell you the following. Naught 0.1 to naught .5 means you’re
not in Ketosis. naught 0.5 to 1.5 is that a light ketosis,
1.5 to three is kind of the optimum sweet spot for pick doses and anything above 3 doesn’t
really add anything. Now we’re talking about blood ketone figures
here now because by far the most accurate way to measure ketone levels is using blood
ketone readings. Urine keto sticks don’t really give us that
much information about how high the level of Ketosis is and they tend to be less accurate
after several weeks of being in ketosis. So it’s blood ketone levels that we’ll be talking
about in this video. Now it’s all very well giving me a set of
rules to live by and you can take those numbers I gave you earlier for what you will, but
personally I’m never really going to fully embrace a set of rules until I understand
the why behind them. So, I did some thinking. I saw those numbers and I thought we need
to dive deeper and really try and understand, you know what? What do they mean? So I’m going
to take you through step by step and you might be surprised by the outcome. In order to get
started, we need to understand what do ketone levels really tell us? What do they mean?
Well, to answer these questions, we need to go back a step and understand the following
things. What factors affect our blood ketone levels, the levels of ketones and anything
for that matter is really dependent on two different things.
The rate at which ketones are being produced versus the rate at which ketones are being
used up. What affects the rate at which ketones had been produced? While ketones are being
produced by the body all the time just at really low levels. If you test the blood ketone
levels of someone who is a carb burner, you’re going to get a reading of naught 0.1
ketones are produced by the liver and in order to produce them in any great amounts, we need
to not be burning dietary or stored carbohydrates for fuel. In fact, we need to have a low insulin
levels and raised glucagon levels. Now we’ve talked about insulin a lot on this channel.
Insulin is the main fat storage hormone, but Glucagon is like the opposite. It encourages
fat breakdown so we can achieve these states by a very low carbohydrate diet or intimate
and fasting or probably both. And under these conditions, the liver will
produce ketones from our bodies stored fat, but ketones can also be made from dietary
fat. Many of you all know that medium chain triglycerides switches from coconut oil can’t
be stored by the body and are therefore turn into ketones by the liver. It’s one of the
reasons that coconut oil has become so popular, but increased dietary fat in general will
lead to higher levels of ketone being produced by the liver.
And you’ll find many people across the internet telling you to increase your fat intake in
order to increase your ketone levels. And yes, it works, but is it the right thing to
do? Whilst Ketosis is great because it tells us that we’re burning fat. It doesn’t tell
us where that fat is coming from. Is it your body fat or from fat that you’ve eaten?
The level of Ketosis can’t tell you the difference between the two. Let’s now look at things
that cause a lower production of ketones. So obviously too many carbohydrates, it goes
without saying, but can this mean too many carbs will mean your body will largely shut
off ketosis. Secondly, the dawn effect, you will naturally
produce less ketones in the early morning due to the dawn effect. Now, the dawn effect
occurs due to a surge of hormones such as cortisol, which will produce more blood glucose
from protein in the early hours of the morning. It does so in order to prepare your body for
the day, there’s not a lot you can do about this, but it is a good reason not to check
your ketone levels first thing in the morning. And thirdly, protein intake is often said
that consuming a lot of protein may also cause lower levels of blood ketones as our bodies
create glucose from the protein that we consume. In fact, we now know that protein consumption
actually has very minimal effects on levels of blood glucose due to the different way
that protein is being used. While the body is in a state of ketosis, but the level of
ketones in the blood isn’t just dependent on the rate that they’re being produced by
the liver. We also have to think about how fast they
are being used up by the body. So, what affects the rate that ketones are being used up?
Well, ketones are an energy source for tissues of the body. So, if the body is using them
in increased amounts, then you’d expect lower levels. So, what would cause this?
Well, firstly and most obviously exercise. We see lower levels of ketones in the blood
after exercise. Test it for yourself, just check ketones before and after an intense
workout. Secondly, Keto adaptation. If your body has
been burning carbohydrates for fuel or it’s life your cells won’t burn ketones as efficiently
as they will after a few weeks or months in Ketosis.
There are changes at the cellular level, which will mean increased burning of ketones when
you become adapted. So now we can answer the question what the high levels of ketones actually
tell us. We now know the things that increase and decrease our blood ketone levels. And
so, we can work out that you couldn’t raise your blood ketone levels by consuming more
fat. Now your body isn’t just going to let your
ketone levels rise and rise. That would be dangerous. So what is it going to do? Well,
it’s going to start to down regulate the amount of fat that is being released from your own
fat stores. Now if you’re trying to lose body fat, then downregulating the use of your own
body fat for the sake of increasing ketone levels isn’t exactly ideal number to do. Less
exercise, doing less exercise for the sake of keeping your ketone levels high as perhaps
more obviously counter intuitive. But I have seen people on the Internet telling
people to reduce their exercise specifically to keep their blood ketone levels raised.
Seems crazy, right? So, I say do that exercise, burn those ketones, build those muscles, make
your muscles more insulin sensitive and your body will have to upregulate the quantity
of ketones is producing and will in fact increased body fat breakdown in order to compensate.
And number three, cutting protein intake. This is perhaps the most concerning piece
of advice that I heard. You need, how much protein you need. You can’t just reduce protein
below this level without causing some harm. Now, protein is important for several reasons.
Number 1, most notably muscle repair and tissue growth. Secondly, proteins also really a very
filling nutrient and thirdly, most sources of proteins are also important sources of
micronutrients. That’s the vitamins and minerals that make up the rest of everything.
When we take macronutrients out of the picture, the amount of protein that you need will be
based on several things including your activity levels and the type of activity that you do.
So, for example, if you lift lots of heavy weights, you’ll do more muscle damage. Therefore
you will need more for repair and growth. The last thing we want to do is consume too
little protein in order to chase high ketone levels. If we do, we run the risk of not having
sufficient protein intake to maintain lean muscle mass.
It’s fat you want to lose, not muscle, so are more ketones really better. Now I agree
that under naught 0.5 you’re probably not really burning many ketones at all. You might
still be losing weight, but perhaps not as much as you could be, but really above naught
0.5 you’re definitely in a light ketosis and really anything greater than one is fantastic.
It should be easy to achieve these levels by eating a well formulated low carb diet
such as what I’m going to describe to you shortly. I wouldn’t go increasing your fat
intake and decreasing exercise or reducing protein intake in order to purely get to higher
levels of ketones for the sake of it. And if it’s still less than one and you’re still
losing weight, well you’re still losing weight. Great stuff.
Unfortunately, I think the word keto has come to mean consuming fat for the sake of consuming
fat in many circles, often at the expense of getting adequate protein, vitamins and
minerals from good quality, unprocessed sources of food. Carb should be a level which doesn’t
turn off your fat burning and turn you into a carb burner locking your those fat stores
so they can’t be used and that level is different for all of us.
Protein should be at a level which your body needs. Even if this costs you a few points
on your ketone readings. If you’re like me and you do quite a lot of resistance training,
you want to really prioritize getting your protein in above anything else. Fat, should
be used to satisfy your hunger and not just added to boost ketone levels for the sake
of it. If the amount of fat you need to keep full
results in levels of ketones or 2 or 3, then that is fine, but don’t chase the higher figures
just for the sake of it. Much better to focus on real food sources which will give you loads
of great vitamins and minerals along with it. That’s why I tend not to recommend things
like bulletproof coffee. The exception to this is in the first few weeks or months of
switching to a ketogenic diet when adding, in fact can help your body get used to using
fat as the primary source of fuel. Things like bulletproof coffee or fat bombs
can be really useful at this stage, but they’re usually pretty lacking in other vitamins and
minerals, so I don’t find this to be a useful long term strategy. Before we finish, I want
to share with you something that illustrates the problem that I’m talking about. I found
this comment on another YouTube channel while I was researching this video, which I think
really illustrates the problem, and so this guy in the comments says:
I was just having this problem. I’ve been on keto for three and a half weeks and I’m
down 17 pounds, but my ketone levels dropped over the last five days. I’ve gone from pretty
steady one to 1.8 all the way down to naught 0.5 I’m going to try upping the fats and see
what happens. Now, this person is clearly getting great
results on their to genetic diet, but they’re focusing on their ketone levels.
Instead of keeping doing what they’re doing, which is helping them to lose weight because
they’re chasing ketones, they’ve identified reduced ketones as the problem. Despite that
the fact that they’re losing way and they’re trying to fix the problem with the key, which
isn’t a problem. Just for clarification, I’m not saying that these high ketone levels are
bad per se, and you shouldn’t be worried if these are the readings you’re getting. I’m
just saying that if you’re getting readings of worn or even less, if you’re achieving
your goals, then don’t stress out about aiming for levels of two or three just for the sake
of it, especially if it means cutting down on your protein and consuming extra fat. So,
in summary, be in ketosis, but don’t chase those higher figures. Try to remember what
you’re trying to achieve. If you’re trying to lose weight, then the main thing you should
be tracking is your weight. If you’re trying to lose size, then the most
important thing to be tracking is your physical measurements. And if you’re trying to improve
your type two diabetes, then you’ll want to be checking your blood glucose levels and
your HBA one c levels, chase the results you’re after, not the ketone levels.
They can easily mislead you. By all means, use them for a bit of troubleshooting. If
you’re finding you hit a plateau or you’re not achieving your goals, but they’re most
useful for checking whether you’re not in ketosis at all, in my opinion, but if you’re
achieving your goals, don’t stress about it. I didn’t check my ketone levels once during
my weight loss journey and I still managed to consistently lose weight for six months.
I don’t check them on a regular basis now either. Thanks for watching. I hope you found
this video useful. Please give it a thumbs up if you have enjoyed it. I here every Tuesday
with new video, so make sure you hit the subscribe button down below this video. I’ll see you
next week.

78 thoughts on “Ketosis: What is the ideal blood ketone level for weight loss?

  1. Thanks for this because this whole Keto thing is driving me nuts!! Should I do full Keto…just low carb…ugh!! Thanks for all of this!

  2. I do hope you get found by viewers looking for clear and well-presented info on the ketogenic diet. I have watched SO MANY videos, some excellent and some not so much. I believe you present the best overall explanation that I've seen. Furthermore, I appreciate your practical, yet scientific approach.

    When you did your deep ketosis, did you notice the loss of muscle mass visually, Or did you notice the effects it had when you exercised, OR did you only realize it because you measured it? Clearly, the answer could include more than one of these.

  3. Fantastic Dan, just the knowledge I was waiting for. I’ve noticed muscle loss following increased fats cos I plateaued with weight loss.
    I’ll revert to less fat and maintain protein levels and see how I go. I’ve never measured ketones yet!

  4. great info and video Dan !especially since I am trying to lose wt. doing this—but I am not consistent and fall off the wagon a bit !

  5. Another Fantastic video Dan! Really informative. Thank you. Clear and really great set of info throughout the whole set of videos so far. Great job. Look forward to the next one!!

  6. Dr Dan, thank you so much for this video. My husband is going through his weight loss journey and really enjoys your videos. Thank you for the information. Just got a new subscriber #154.

  7. This is such great info! I really like how you explain this in an easy to understand way and share your own experience in this video. (Btw, nice graphics!)

  8. I have used the Freestyle Libre glucose/ketone reader. I have used the continuous glucose reader and it told me a lot about my eating habits. Low blood glucose results in elevated ketones. I found that morning dawn effect of increased glucose resulted in lower blood ketones. After fasting for 18-23 hours my ketones are the highest and I can get up to 1.7 mil/litre and at this time my blood glucose was in the low 4s. During this time I lost about 2 pounds per week. The CGM showed me how my blood glucose increased after a meal and it never went about 6.0….. a CGM is an amazing tool for understanding your eating habits and how excersize affects your blood sugars. I strongly recommend a CGM for learning more about how your habits affect your blood sugars

  9. Good one. But I'm still confused. If I'm in the "ideal range" – I'm usually around 1.5 mmol – how many food can I eat/should I eat to still loose body fat? How can I be sure not just burning nutritional fat into ketones without loosing weight?

  10. Thank you so much for this information. I'm one week in and so confused. This has helped me so much.

  11. Thank god I found you…you do a great job of explaining all the principles of the Ketosis levels!

  12. Being on ketosis simply means the body is using ketones for fuel, hence when once fat adapted, exercise to utitlize the fat as energy and eat protein for muscle repair. Fasting helps the body to use up the stored fat. Better still exercise while fasted.

  13. Love this I’ve not been doing long ,was totally confused with all information and the difference to technical ,this is simple and to the point thankyou

  14. I don't know, I don't seem to have the dawn effect, I wake and have a level of 6mmol/l ………. this has been going on for 2 months, then it builds higher to like 13mmol/l…!…… and pretty much stays there…… my glucose is low normal….. so, Im not sure what to make of it…… maybe I need a few more carbs?

  15. hello doctor I'm doing a ketogenic diet and one meal a day, today I didn't eat and lifted lot of weights in the gym and my ketones is 3,8 is that normal?

  16. You really just helped me so so much. You just simplified ketosis and are now going to make my journey so much easier. Thank you

  17. Just found you on YouTube. Loved your presentation. This comment applies to 2 of your videos, the one about when to measure and this one about what is the ideal ketone level. I'm a data geek (I'm an engineer after all), data is important, but not the goal, only a way to monitor your body's reaction to events (diet, exerciser, sleep, etc.). Ketone measures are important and relevant, but you need to understand what they indicate. I do measure my blood ketones, but just to ensure I've not inadvertently eaten something that kicks me out of Ketosis. One thing you did not touch on was the use of exogenous Ketones. It seems to me that using them is, again, misunderstanding the goal. Yes, they will raise your ketone levels, but not as a result of burning your stored fat, which is the goal of most people – me included.

    I use the Ketone measurment also to experiment my body's ability to metabolize different items on which I'm not clear the effect the item my have. I do this by taking a measurement just prior to eating the item in question, then a reading every 15 minutes until my blood sugar is back to normal ( I measure both Ketones and Blood sugar). Due to the cost involved with the ketone strips, I limit my experimentation to only when I cannot determine the effect of the item by other , less expensive methods.
    Thank you for your very clear, and common sense explanations.

  18. Just found your channel this week, now I'm hooked… Excellent, Great information Dr. Maggs! Thanks so much for educating us, answering our doubts, and helping us achieve a much healthier way of living! Keep up with your great work!

  19. Maggs the man. I´m a 60 yr young man from Finland, not new to keto, I was in carb hell all summer. Blood 6.5 and triglys over two, yikes. Glad I found you. Smashed that sub and bell really hard:) The dawn affect huh? That explains so much. I´ve been 90% carnivore for a couple of weeks and disapointed that my blood is still 6.5( waking up). A few yrs ago my blood was 6.8 and in three weeks of keto it droped to 4.7. Now I started using a keto meter and yesterday I was 0.7 and this morning 0.3 with blood again 6.5. Well, won´t be measuring in the morn anymore:) I´m doing IF and eating pretty much in a 5 hour window. A few times it´s just been one meal. I´ve, in the past, done extended fasts the longest being 22 days. I started out to fast for only three days but it was so easy and felt fantastic. I lost 15 kg in that time but gained 8 back in a few months. Happy for the lost seven kg but I´m still really over weight . Now I´ve come down from 116kg to 110kg in three weeks and my gut is noticabily smaller, yay:) would love to here your thoughts on a three or four day fast. I´m not feeling hunger and it would be very easy to start a fast. I know you can´t give me medical advice and thats not what I´m looking for. Just your thoughts on the benefits of maybe adapting faster to ketones. Sorry for the long rant, I´m just so happy I was finally able to start keto again. Forgive any spelling mistakes or dificulty understanding my written thoughs. I speak English way better than I write. Had to give English a go as I figured you might not speak Finnish:) I´ve watched just a few of your vids but will go through all I find. See what I did there with the word thru:)? Here´s wishing you great success on You Tube and have a fantastic end of 2019.

  20. There are many reasons for following a ketogenic diet beyond primarily weight loss (migraine abatement, anti-infam and pain management effects, gut issues etc) but the appetite suppressant effect of ketosis is of MAJOR benefit to dieters. It is the most liberating side-effect of ketosis for a huge number of food addicted, long term obese folks

  21. Thanks for THE informative video. I have had this belief, despite what the video gurus were saying.
    My question is this… Once in keto, and you have plateaued, how can you MAKE SURE that you STAY in keto, while eating proper fats and proteins?
    One other question… Let's say you haven't had carbs or sugar in a year, and then eat a candy bar. How far is that going to set you back? Will it throw you out of keto, manifestly?

  22. I checked my ketones after i did cheat meals /days, to understand how it affected me. I periodically check ketones on weekly basis and weigh myself everyday, as my current goal is to loose weight. Thanks for the video, it's clear and confirm my understanding about ketones.

  23. It's refreshing to get an accurate account of keto related science from a doctor who articulates the information in such a clear and eloquent fashion. Thank you.

  24. I’ve been maintaining high ketone levels in the 3.2 range with normal glucose levels of 75-80 ml for 2 weeks now and have only dropped 2 lbs. So this video definitely makes sense.

  25. Thanks Dan, That question has been bothering me for some time now, Like Kim commented , "youre making the journey so much easier" keep up the great videos chap, best wishes from Canada eh!

  26. Thanks for such a informative and useful information, please keep it up. Job well done. Surly you cleared up a lot confusion about KETO diet. Thanks again

  27. New to keto. Done it before but not seriously. The keto community is sincerely brilliant so sweet patient and loaded with knowledge. Thanks to everyone!

  28. You’ve really cleared up some things for me! I’ve been eating a keto diet for 3 yrs, and can’t get the last 20-30 lbs off. I just bought a mojo meter and trying to use that to find out what is going on. I’m going to stop taking my early morning fasting glucose and ketones. I’m an RN, we always take a fasting early morning glucose for our patients, even knowing about the Dawn effect. Your video here is the clearest explanation I’ve found about protein, fats, carbs and ketones. Some common explanations out there were not making sense to me. Your advice to “chase what result you are after “ is VERY refreshing to say the least. Thank you.

  29. I'm not Diabetic and Doing Alternate Day Fasting and I tested 6.1 tonight. This from a person before AD Fasting had a high of 1.5. One meal in 2 days 7oz of pork and 5oz of cheese and walking 30min.

  30. I have been keto for a year with great ketone levels. Switched to carnivore and my ketone levels are in the toilet?!?!?! Should I be concerned? I am eating meat that has fat— just uncomfortable with the low ketones. Will this level out as I go along with carnivore?

  31. I haven't checked keytone levels (2 1/2 month on Keto). The higher fat has helped me stay with Keto BUT I can tell it will be better to cut down on fat and have a little more protein. I'm not using a scale either. I am going by my clothes. I have resisted making Keto treats (maybe 2 things in 2 1/2 months). But I've been longing for all the things I loved, like bread and butter, etc. So I made muffins tonight to keep me from bingeing. I'm staying with Keto coffee as a lifeline. But I'm ready to step it up and do what Dr. Maggs is saying. I am on his page intuitively.

  32. so, at this time, I want fat loss, I want higher ketones for health and how good I feel at the higher levels, but sounds like I need to wait until I meet my weight goals, and then increase the ketones? and another question, my glycose use to run around 100, now it runs in the 70s, but occasionally drops breifly to the 50s, without any hypoglycemic symptoms, is this ok?

  33. I started my keto diet on 1st jan. I checked my keto today with a urine strip it was 1.5 is that ok? I'm just delighted that it works and am looking forward to some weight loss.

  34. While I agree with you mostly, the only thing I disagree about is if a person is morbidly obese and cannot exercise because of weight right now, then who cares about exercise. And if you have 100+ pounds of fat to lose, you're not going to mind losing 5 pounds of muscle. You can put that back on when you're able to get moving again after dropping some of that fat weight.

  35. I have lost 30 pounds in 4 months while I have smaller friends (in size) losing about the same in WAY less time. Any suggestions?

  36. This is a great video.  

    What sooooo many people fail to understand is that if you have been keto for several months AND you are at your proper body weight, your blood ketones levels will naturally drop because your body has been optimized to using ketones as a fuel substrate.

    A fun test to do is to take a short nap in the afternoon and then immediately test your ketones levels. If you see a significant rise in ketones, that means your body is actively burning ketones for fuel. Because your metabolism drops during the nap, your ketones will rise until you wake up and start moving around again.

  37. Just found your channel and I’m so thankful! I’ve been keto since June of 2019. I’ve lost almost 30 pounds but still need to lose 15-20 more. I’ve been “stuck” for the last two months! I have hypothyroidism so now I understand why I’m not losing. Do you have a video on how to get over the plateau with this? You are so methodical and easy to understand! Your science seems right on the money! Thank you for sharing your knowledge.

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