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What Is The Ideal Ketosis Level For Weight Loss? How To Monitor Ketones

If you’re interested in learning about the best diets for weight loss, then you’ve probably heard about ketosis and the keto diet. This high-fat diet continues to gain popularity among the masses for its delicious meals and the promise of quick results. 

The ketosis process is the powerhouse behind your body being able to use and burn fat, which is said to lead to weight loss. Finding the optimal ketone level is a secret that not many know about that can help them maximize their weight loss results while on this diet.

In this article we’re going to look at the ideal ketosis level for weight loss, how to reach it, how to measure your ketone levels to ensure that you reach the perfect level, and much more.

Ketones: What Are They?

Before we delve into the ideal ketosis level for weight loss, what are ketones and why are they important?

We all have ketones in our bodies in varying amounts. They are chemicals that are produced by the liver during any fasting period for the following reasons (11, 3):

As a fuel alternative

Our bodies generally run on glucose, which comes from the carbohydrates we consume. When the carbs available in the body decrease, this means the body doesn’t have enough glucose to burn for energy.

Once this happens, the body turns to fats, which it processes into ketones, and uses them as an energy source.

You have diabetes

In this case, your body has glucose in its blood, but it doesn’t have enough insulin or isn’t sensitive enough to it to help your cells absorb the glucose and use it. To keep you going and supply you with energy, the body then starts breaking down fat into ketones to use as fuel.

Starvation

You’ve gone for a long period without eating and your body has already used up any carbs you ingested and turned to its glucose stores and depleted them too. It now has no choice but to turn to fatty acids and convert them to ketones for energy.

When the body breaks down its stored fats to use them as energy, these ketones (aka ketone bodies) are used to fuel everything from the brain to the muscles and other tissues.

Our bodies produce three different types of ketone bodies (10):

  • Beta-hydroxybutyrate (BHB)
  • Acetoacetate
  • Acetone

Acetoacetate (AcAc) and 3-beta-hydroxybutyrate (BHB/3HB) are used as a fuel source by the body. Acetone is much less abundant, but it has been linked to fruity-smelling breath.

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What Is the Ideal Ketosis Level for Weight Loss?

The first thing to note is that you won’t reach an optimal ketone level on the first day of a keto diet. Like everything else, your body needs time to adjust to the new diet and way of doing things.

According to Healthline, not only will you not reach this level in a day, you won’t even go into ketosis immediately after starting this diet. It may take anything from 2 to 4 days to actually enter ketosis (8).

The main reason behind this is that even after you cut out carbs – the main source of glucose for the body – your body still has stores of carbs in the form of glycogen in the liver and muscles.

Once glucose is no longer readily available due to the lack of carb intake, your body will burn through its glycogen stores and convert protein into glucose before it finally turns to burning fat, which starts the ketosis process and ketone production. This is where you can start measuring your ketosis level. 

But what is the optimal ketosis level for fat and weight loss?

Based on two scientific reviews that both cite a book that was published in 2012, the ideal ketosis blood level for weight loss is between 0.5 to 3.0 millimoles per liter  (mmol/L). According to the researchers, this range indicates that your body is in what is known as nutritional ketosis. 

Nutritional ketosis is defined as the “intentional restriction of dietary carbohydrate intake to accelerate the production of ketones and induce a metabolic effect that stabilizes blood sugar, minimizes insulin release, and thereby mitigates the downstream anabolic and tumorigenic effects of longstanding insulin resistance” (14).

 

Nutritional ketosis is the goal of keto dieters and several studies have suggested that this state may have benefits for weight loss and general health: 

1. In 2013, a meta-analysis of 13 studies with over 1,500 participants published in the British Journal of Nutrition found that when compared with basic low-fat diets, very low-carbohydrate ketogenic diets resulted in greater weight loss.

Such diets were also found to be associated with decreased diastolic blood pressure and triglycerides and increased HDL cholesterol (18). However, they were also associated with increased LDL (“bad”) cholesterol, which is not a desired outcome.

2. An earlier review in 2012 also found that low-carbohydrate diets produced significant weight loss and general health results. 

These meal plans helped reduce body weight, body mass index (BMI), abdominal circumference, systolic blood pressure, plasma triglycerides, diastolic blood pressure, and glycated hemoglobin, among other factors related to a higher risk of cardiovascular illnesses (17). 

A point to note is that this review, unlike the one published a year later, did not find any significant change in LDL cholesterol.

Please note:

Once you have consistently followed the ketogenic diet for a while and your body has continued to stay in nutritional ketosis, you should fall into keto adaptation – a more stable state of ketosis. 

Also known as fat-adaptation, this is a process your body goes through as it changes from using primarily glucose to using primarily fat for energy. This process is not immediate and needs some time.

According to several studies, after entering ketosis, keto adaptation may take anything from 4 weeks to 12 weeks to occur. The speed is determined by your individual make-up and how strict you are with the meal plan, although in athletes, the process has been shown to occur faster – as little as 2 weeks (9, 12, 7, 5).

Read more: Is Pho Keto? The Ultimate Guide to Enjoying Pho on a Low-Carb Diet

Does Higher Ketones Mean More Weight Loss?

No. In fact, a higher ketone level may be an indicator that you need to seek immediate medical attention.

As demonstrated above, the ideal ketone level in the blood is between 0.5 and 3.0 mmol/L. The easiest way to measure ketones at home is in the urine. Urine ketone tests use a different unit of measure – milligrams per deciliter (mg/dL). Your test kit may list a specific number or simply indicate “small”, “moderate”, or “large” ketone levels. Talk to your healthcare provider about what levels are considered normal for you and what may indicate that you need to seek medical attention (22). 

This is particularly important for people suffering from diabetes. High ketone levels in urine, particularly in diabetes patients, can be an indication of diabetic ketoacidosis, a life-threatening condition that has a 2 to 10 percent death rate (15).

Diabetic ketoacidosis ketone levels are said to be anywhere between 5 to 15 times higher than normal nutritional ketosis levels. Diabetic ketoacidosis (aka DKA) can be symptomized by signs such as (21):

  1. Polydipsia and/or polyuria (aka excessive thirst and/or urination)
  2. Panting, deep breathing, or respiratory failure
  3. Abdominal pain
  4. Unexplained and unintentional weight loss
  5. Lethargy and weakness
  6. Some people may fall into a coma

To be on the safe side, you should talk to your healthcare provider in advance and know what level may require you to seek medical attention (14).

When Is the Best Time to Test Ketones in Urine?

Urine testing for ketones is one of the easiest ways to see if you’ve reached the ideal level according to the ketosis level chart. 

The urine test is done using urine stripes that change color based on the presence of the ketone acetoacetate. These strips are often sold over the counter with each package containing anywhere between 50 to 100 strips.

So when is the best time to test for your ketone levels using these strips? 

According to a study published in 2016, the best time to do this urine test is either very early in the morning or late at night after dinner. In the study, researchers found that the detection was highest and most reliable at 7 am, 10 pm, and 3 am (13).

What Is the Ideal Keto Weight Loss Timeline?

There is no such thing as an ideal keto weight loss timeline. There are no milestones that you should look out for on this diet. Remember that keto is like any other diet and is not a miracle worker. 

The amount of weight you lose is determined by several factors, including your calorie intake, how strict you are with your diet (are you constantly cheating and eating more carbs than recommended?), how much you exercise (if at all), age, genetic factors, and much more (6).

It’s important to remember that weight loss is not a race and someone else’s success is not an indication of your failure. As long as you consistently follow the diet rules as closely as possible, eating at a calorie deficit and exercising for at least 30 minutes a day, you’ll be fine.

Aim for a healthy pace of weight loss of 1 to 2 pounds a week and you’ll achieve your goals in no time.

 

Is 8.0 a Good Ketone Level?

It depends on what unit you’re referring to and whether you’re measuring the blood or urine. The ideal ketosis level in the blood is believed to be much lower – between 0.3 and 3 mmol/L. However, urine ketones are considered “small” if they’re under 20 mg/dL. 

Remember, ketone levels in the blood or urine that are too high are not good for you. Symptoms of this range from simple fruity-smelling breath, weakness, and vomiting to more serious issues such as respiratory failure, coma, and even death (21).

Talk to your healthcare provider about what blood and/or urine ketone levels are considered normal for you based on individual factors, medical history, and diet. 

80 mg/dL Ketones in Urine Keto Diet: What to Do

If you use a urine strip to monitor your ketones and the number reads 80 mg/dL, you should test again. If you still get a reading of moderate (>40 mg/dL) or large (>80 mg/dL), you should call your doctor immediately and take whatever actions you discussed with them beforehand should this situation arise. l. As previously mentioned, if you have diabetes, such high numbers may be an indicator of diabetic ketoacidosis.

Also known as diabetic acidosis or DKA, it is a serious complication of diabetes that can be life-threatening. The condition is more common in people who suffer from type 1 diabetes, although those with type 2 diabetes have also been known to get it (1).

This condition is also shown by symptoms such as frequent urination, constant thirst, headaches, exhaustion, stiff or aching muscles, fast, deep breathing, a flushed face, and stomach pain. Failure to treat DKA can lead to a coma or even death (4).

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How to Hit and Maintain the Ideal Ketosis Level for Weight Loss

The easiest way to do this is simply to follow the ketogenic diet rules and exercise regularly. Keep your daily carbohydrate intake to less than 50 grams a day – about 20 to 50 grams is best – and stick to only eating keto-friendly foods.

Basically, you should commit to the meal plan and your goals. Remember that too many cheat days can be fun, but may hamper your progress. Another hack to stick to less than 50 grams of carbs a day is to buy or prepare snacks with no carbs.

There are over 80 keto snacks to choose from, but the most accessible ones include:

  • Egg muffins or boiled eggs
  • High-protein lettuce wraps
  • Cheese chips and string cheese
  • Canned fish
  • Pickles
  • Celery sticks
  • Pork rinds
  • Pepperoni slices

Read more: 6 Keto Sushi Recipes to Eat on a Low-Carb Diet

 

FAQs

  • How can I speed up my ketosis weight loss?

The easiest way to speed up any weight loss – not just ketosis weight loss – is through increased physical activity. If you haven’t been exercising even after changing your diet, you should start.

If you were already working out, your body may have already become used to this exercise, so switch things up. Increase the intensity of your workouts or the time you spend working out to help you burn more calories.

  • What are the first signs of ketosis?

Some signs that can tell you your body is finally in ketosis include (19):

  1. Increased ketones – This is only realized if you’ve been keeping track of your ketone levels through urine or blood tests
  2. Increased thirst – Higher ketone levels can dehydrate you, which means you end up drinking more water
  3. Muscle cramps and spasms – This is due to the aforementioned dehydration, in addition to an electrolyte imbalance
  4. Headaches – Due to a lower carbohydrate intake than the body is used to, in addition to dehydration and electrolyte imbalances
  5. Bad breath – Specifically due to the ketone, acetone
  • Can you physically feel ketosis?

Yes, you sometimes can. When your body goes into ketosis, it notifies you through some physical signs. This is known as the keto flu and can happen anywhere between two and seven days after you start the ketogenic meal plan (20).

  • Why am I in ketosis but not losing weight?

Reasons why you are in ketosis but not seeing the expected weight loss results include (16):

  1. You’re not working out – This helps you burn more calories, leading to better weight and fat loss results.
  2. You’re eating too many carbs – You can’t maintain ketosis if your carb intake is still higher than recommended.
  3. You’re eating too much or too little protein – Protein helps keep you feeling fuller for longer and also boosts your metabolism, so it’s important in any weight loss diet. However, eating too much of it while on this specific eating plan may knock you out of ketosis if it’s converted to glucose by the body.

It’s important to remember that keto is highly dependent on fat intake. Find the perfect fat and protein intake for both weight loss and ketosis.

  1. You’re not in a calorie deficit – Calorie intake is not often mentioned when talking about the ketogenic diet, but it’s essential if you want to lose the extra weight.
  2. You’re not keeping your eye on your alcohol intake – Alcohol is mostly empty calories and is high in both carbs and sugars. Nothing about it helps you maintain a state of ketosis.
  3. Stress or underlying medical conditions – If you’re seemingly doing everything right and the scale isn’t going down, it may be time to check your stress levels or visit a doctor.

High stress levels increase cortisol production, which makes weight loss that much harder. Underlying medical conditions such as thyroid issues, depression, and PCOS also hinder weight loss despite dietary and lifestyle changes.

  • Keto vs intermittent fasting: which is better?

If you’re considering one or the other, why not try both? Both options can lead to weight loss, but a combination of both may produce better and faster results. Keto helps your body burn fat and fat stores for energy, which helps with fat loss. 

Intermittent fasting controls when you can eat, which can help keep you in a calorie deficit – if you watch what you eat during the eating window. As the name suggests, it involves fasting, which as we’ve seen above, triggers ketosis.

The Bottom Line

The ideal nutritional ketosis blood level is anything between 0.3 mg/dL and 3 mmol/L. This is believed to be the optimal range that ensures your body is burning fat for energy as you want and you can hopefully lose weight in time.

If your numbers fall below this, we suggest waiting a bit longer before testing again. If it stays the same, re-evaluate your diet and check if you can see where you may be going wrong.

However, a word of caution: while monitoring your ketones is a good plan, don’t obsess over these numbers. As with your weight on a scale, it may lead to more harm than good – both psychologically and physically.

DISCLAIMER:

This article is intended for general informational purposes only and does not serve to address individual circumstances. It is not a substitute for professional advice or help and should not be relied on for making any kind of decision-making. Any action taken as a direct or indirect result of the information in this article is entirely at your own risk and is your sole responsibility.

BetterMe, its content staff, and its medical advisors accept no responsibility for inaccuracies, errors, misstatements, inconsistencies, or omissions and specifically disclaim any liability, loss or risk, personal, professional or otherwise, which may be incurred as a consequence, directly or indirectly, of the use and/or application of any content.

You should always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or your specific situation. Never disregard professional medical advice or delay seeking it because of BetterMe content. If you suspect or think you may have a medical emergency, call your doctor.

SOURCES:

  1. Adult Diabetic Ketoacidosis (2023, ncbi.nlm.nih.gov)
  2. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets (2013, ncbi.nlm.nih.gov)
  3. Biochemistry, Ketogenesis (2023, ncbi.nlm.nih.gov)
  4. Diabetic Ketoacidosis (2021, cdc.gov)
  5. Effect of 6-month adherence to a very low carbohydrate diet program (2002, pubmed.ncbi.nlm.nih.gov)
  6. Factors affecting weight loss variability in obesity (2020, sciencedirect.com)
  7. Fat adaptation in well-trained athletes: effects on cell metabolism (2011, pubmed.ncbi.nlm.nih.gov)
  8. How Long Does It Take to Enter Ketosis? (2023, healthline.com)
  9. Keto-Adaptation and Endurance Exercise Capacity, Fatigue Recovery, and Exercise-Induced Muscle and Organ Damage Prevention: A Narrative Review (2019, ncbi.nlm.nih.gov)
  10. Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes (2000, onlinelibrary.wiley.com)
  11. Ketones (n.d., dtc.ucsf.edu)
  12. Long-term effects of a ketogenic diet in obese patients (2004, ncbi.nlm.nih.gov)
  13. Monitoring for compliance with a ketogenic diet: what is the best time of day to test for urinary ketosis? (2016, nutritionandmetabolism.biomedcentral.com)
  14. Nutritional Ketosis for Weight Management and Reversal of Metabolic Syndrome (2018, ncbi.nlm.nih.gov)
  15. Prognostic Factors in Patients Hospitalized with Diabetic Ketoacidosis (2016, ncbi.nlm.nih.gov)
  16. Reasons for not losing weight on a keto diet (2023, medicalnewstoday.com)
  17. Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors (2012, pubmed.ncbi.nlm.nih.gov)
  18. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials (2013, pubmed.ncbi.nlm.nih.gov)
  19. What are the signs of ketosis? (2023, medicalnewstoday.com)
  20. What is keto flu? (2018, health.harvard.edu)
  21. What is ketonemia? (2023, medicalnewstoday.com)
  22. Ketones in Urine (n.d., medlineplus.gov) 
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