Any explanations as for why I've got ketones?

Hi all,

I'm hoping someone may be able to help explain what is going on with me recently. I have been experiencing moderate to lg ketones off an on only recently. It seems to be happening way more frequently now that I am on a lower carb diet. I'm eating about 50-100 carbs per day. Prior to this new diet I could hit the 300's and still not worry about ketones. Now, if I do hit 300 I get almost immediate moderate to lg ketones. I know it's happening b/c I'll feel very nauseated and typical high bs symptoms. I correct (on a pump) and the ketones generally go down but it takes sometimes a day or longer. Do I go back to eating more carbs? I feel like overall my bg's are better when I reduce my carbs, but the ketones are becoming problematic, meaning it's happening once a week or more where I am struggling with nausea and trying to rid my body of ketones. I've researched this and saw that infections and stress also cause ketones. Definitely have LOTS of stress but not abnormal for me. No infection that I am aware what is causing this? Thanks for any help!

Even non-diabetic people produce ketones when they're on a very low carb, high protein diet. Ketones are a byproduct of the body's use of fat for fuel instead of glucose. While many diabetics do quite well on a low-carb diet, you apparently do not. Perhaps you could add just a few carbs (maybe staying around 100 per day instead of 50?) and see if that solves the problem? You may have to do some experimenting, but you can probably find a threshold that works for you, keeping carbs moderate but not so low that you produce ketones?


That's great! Especially if you'd like to lose weight. Have you tested your ketones when your bs is normal? My guess is they're high then, too.

I'm not sure what to say about the nausea. I've never heard of that from ketosis. I always feel great when I'm in ketosis. Is it possible that the nausea is from something else? I wonder if you were able to keep your blood sugar from going high like that if you'd stop having the nausea. I'm surprised you're having those highs while eating so few carbs.

eta: It's a totally normal healthy state to have high ketones when you're eating low carb.

Are you exercising a lot and low carbing it? Burning fat during exercise can also produce ketones.

I have eaten a very low carb diet for a lot of years, had high stress jobs, and am not an exerciser. I only have ketones when glucose runs over 300 for several hours, which is almost never. I eat about 45 carbs on a normal day--not always, but most of the time.

Thanks to all for the info. I guess maybe it's just normal for me to have ketones when eating lower carb than normal. I am someone who use to eat ALOT of carbs so maybe this is just my body getting used to the change. I do have small ketones today but bs is normal and no nausea. The nausea seems to come when ketones are moderate or large. One thing that is weird though is that it seems I'm going to need to bolus even when eating only protein. Anyone else experience this and how do you figure out how much?

Generally when you switch from a normal-carb diet to a low-carb diet, your body will generate a higher amount of keytones. As your body adapts and you become more efficient using protein, fat, and keytones for fuel, your urine ketone levels will drop. I have been following a low-carb diet for a long time and I don't see excess keytones in my urine anymore unless I skip a meal or two or exercise a lot. When I eat a lot of protein or eat too many carbs (from cooked non-starchy vegetables), my excess keytones disappear. It took a couple of months to completely adapt to the low-carb diet. I now regularly bike 15-40 miles every day eating < 50 gms of carbs per day.

You're just distinguishing now the glucose that your protein is turning into maybe 2 hours after a meal. I usually figure 1/2 the grams of protein and bolus that that as if that number were carb grams, since 60% of protein turns into glucose. You don't need a high protein diet. e.g., 9 grams protein x.5 = 4.5 Bolus for 4.5 grams. Tweak it as needed.