Measuring Blood Glucose and Ketones

Home blood monitors are screening devices. If you get a questionable result, retest!

Home monitors are only required to be accurate to +/- 20%.

What does this mean to you personally? Example:

1. You test a drop of blood and your meter reads 75 mg/dL.

2. Just out of curiosity, you immediately retest.

3. Your new reading could fall anywhere between 60-90 mg/dL!

Thankfully, most meters are not that erratic.

In the first 2 weeks, test your fasting blood glucose (1st AM).

  • Typically, you will see lower numbers at Day 14 then at Day 1.
  • Use urine ketones strips to detect when you make the shift to ketosis. After that, negative readings are often a “red flag” that you ate or drank a non-keto food in the previous few hours.

In the next two weeks, begin to test at other times as well.

  •  Test blood ketones AND glucose about 2 hours after lunch. (If that’s not convenient, you can test two hours after dinner.)
  • Test at other times of the day as well to learn your range.

Keep a record of your glucose/ketone readings.

  •  Record the day, time, how you felt, when you last ate, and any other info that might affect readings. (Were you stressed or relaxed? Nauseous or feeling great? Shaky or energized?)

Look trends over time. If you graphed your readings, would you see:

  • A drop in glucose?
  • A rise in ketones?

On several occasions, we took our son’s monitor to the clinic and compared his finger-prick reading with his lab draw. The lab result was usually lower than our monitor. We weren’t testing the monitor’s accuracy. Instead, we were looking for consistency. When we started to get some very unusual readings, we replaced the meter.

In the first few days or weeks of a ketogenic diet, your “numbers” may bounce around as your body adapts to this shift in metabolism. This is normal.

Young people are generally more metabolically flexible. As they ease into ketosis, glucose numbers drop quickly (as low as 55-65 mg/dL) and urine ketone levels may be “large” within a day or two.

As we get older, we ALL develop some degree of insulin resistance that can impact our efforts.
Steroid hormones affect glucose levels:

    • You have some control over “fight or flight” reactions. Once the threat has passed, use relaxation techniques to turn off adrenaline or “shift gears” to a lower stress mode.
    • Cortisol is a “stress hormone” but it also has a key role in maintaining health. It should peak just before waking. High levels stimulate glucose production by the liver. This is normal. Expect higher glucose/lower ketones in the morning!
    • Women often see a rise in glucose numbers associated with the beginning of a menstrual cycle. This is normal but can be enhanced by stress. This is a perfect time for de-stressing.

Steroid drugs (prednisone or dexamethasone) stimulate appetite and raise blood glucose levels. Do not stop taking your medication! Instead, ask your doctor for a safe weaning schedule.

GI challenges, inflammation, a large “tumor load”, treatment side effects, or compromised liver/renal functions can interfere with “compliance” and/or act independently to keep glucose high.

Surgery, radiation and chemo are “injuries” your body responds by raising glucose. Be patient and allow yourself time to recover.

Vigorous exercise can cause a rise in blood glucose. Conversely: gentle or moderate exercise (walking, swimming, moderate “weight training”) lowers blood glucose.

Download Top Ketogenic Diet eBook. Click here to download it.

How Long Do I Have to be on Ketogenic Diet?

Stay on “The Ketogenic Diet” until you are keto-adapted. After that, commit to an anticancer ketogenic LIFESTYLE for a LIFETIME!

The first weeks and months are the most challenging. Keto-adaptation happens relatively quickly, usually within the first few weeks or months. However, your mindset may not make that rapid a
shift. Research tells us that it takes several months to develop new habits.

In my experience, people often need 4-6 months to be fully up to speed with a ketogenic plan. Of course, relief from symptoms or an AMAZING scan will strengthen your motivation and resolve!

Download Top Ketogenic Diet eBook. Click here to download it.

Once you’re keto-adapted, play with the plan a bit to see if minor variations impact your glucose/ketone numbers to any significant degree. Eat out when the mood strikes you, knowing that you can now sidestep the common food traps.

View your plan as a flexible anticancer ketogenic lifestyle. That mindset allows you the freedom to grow and change, making better choices and more informed decisions as you continue on your journey. I am NOT suggesting that you allow non-keto foods to sneak back into your ketogenic diet or to take extended keto holidays. Instead, you might switch briefly to a modified Atkins or low glycemic index plan while continuing to test your glucose and ketones.

You’ll derive the greatest long-term benefits if you remain true to the basics:

  • No grains, sugars, or starchy vegetables
  • Only small amounts of berries and certain low-glycemic fruits
  • Keep protein portions limited
  • Limit dairy proteins to condiment-sized portions
  • ALWAYS include LOTS of fats and oils!

Once you are keto-adapted, you may not be hungry when you first wake up. You also might be tired of eggs! Experiment with some new ways to start your day.

  • Enjoy a cup of decaf (or coffee) with cream, unsalted butter, coconut oil, or MCT. That may be all you need for several hours. If not, what else can you have? A keto muffin? Half of an avocado?
  • Another light choice: 2 TBS of chilled European butter rolled in Himalayan sea salt. (Thank you, Trudy, for sharing your treat!)
  • My personal favorite: 1 TBS of almond butter mixed with 2 tsp of coconut oil spread on 4 very thin slices of apple. If I’m taking my usual 1 hour hike, I also eat an ounce of cheddar.

Look back over your first month on the ketogenic diet.

  • Recall the vegetables you used most often. Did you keep your favorites on hand? Did you step out of your comfort zone? If not, what other are you willing to try?
  • How do you currently prepare them? If you steam them, you may need to get creative in order to work in enough fat. Use high-fat sauces or dressings. Some veggies, such as spaghetti squash and
    mashed cauliflower, can hold quite a bit of butter or oil.
  • You can make dips and sauces using sour cream, mayo, extra virgin olive oil, snipped herbs and your choice of seasonings.
  • If you like your veggies sautéed, use lard instead of olive oil. Drizzle extra virgin olive oil on them.
  • Have you tried fermenting vegetables (e.g., sauerkraut or kimchi)? Fermenting lowers the glucose content. Learn more about it online.
  • What are you eating for protein? How do you prepare it? You can put a stir fry meal on the table within minutes if you start with leftovers and heat them in bacon grease or coconut oil. Again,
    seasonings make a huge difference! Add curry for an Asian taste or spice it up with hot sauce for a Mexican meal.
  • Turn your leftover meats into various salads by dicing them up and mixing in some mayo. These salads travel well to work or school and don’t need reheating.
  • Take some weekend time to batch favorite meals or snacks. Having a few ready meals makes it easier to deal with tight work days.

Rotate your foods.

Eating the same foods every day for weeks on end will dull your palate. In some cases, you might even develop intolerances.

  • Mix it up by varying your cooking methods (e.g., slow cooker vs. roasted).
  • Experiment with new foods in making soups and salads. For example, add walnuts and vinaigrette to your Caesar salad.
  • Check out the Keto Recipes on my blog.

Once you are keto-adapted AND at the lower end of normal weight, you may see a rise in fasting blood glucose. Possibilities include:

  • You make less insulin because your body is mostly in “fat-burning mode”. The glucose your body makes as a normal response to your pre-dawn rise in cortisol stays in circulation longer as it is not high enough to provoke an insulin spike. Ignore your first reading of the day and focus on your post-meal number. If they remain low and steady, no worries here!
  • In any case, you may want to engage in some gentle exercise to allow that AM glucose to be taken up by your muscles. Test before you start moving and again when you finish. If your glucose level
    drops, that’s a good indication that your muscle tissue is NOT insulin resistant.
  • Of course, you MAY be insulin resistant. If so, you are likely to have other metabolic markers of pre-diabetes. Discuss this possibility with your healthcare practitioner.

Where do you go from here? That’s up to you.

Your personal data is a treasure trove of information that can guide you to the next point in your journey. Take time to review:

  •  Food records
  • Data on glucose/ketone levels
  • Changes in weight
  • Notes on how you’re feeling now compared to pre-diet
  • Notes on what actions worked to help you reduce stress
  • Changes in clinical symptoms or lab results
  • Changes noted in scans taken 6-8 weeks after reaching ketosis
  • Reflection on what has worked and what remains challenging. You can choose to keep the status quo or test some o changes. Remember, you don’t need a break from this lifestyle. Instead, make
    peace with what you are doing and find ways to make it your own!

Find out more on Top Ketogenic Diet Ebook with Diet Generator. To download the ebook please Click Here.

Ketogenic Diet and Dairy Products


It depends… Let’s start with keto-friendly dairy PROTEINS.

Milk and soft cheeses are too high in lactose (milk sugar) for inclusion in a ketogenic diet. However, some people choose to include hard cheeses. Keep in mind that intake of high PROTEIN dairy increases
blood levels of insulin AND cancer-promoting IGF-1. Given that, you might consider using cheese more like a “condiment” (e.g., 8 grams of Parmesan grated onto a salad).

Note that goat’s milk also contains IGF-1 so the same recommendation of “condiment” sized portions would hold true for goat cheeses. Also, if you gravitate towards goat cheese because you believe they are
raised more humanely, a quick Internet search will set you straight.

Download Top Ketogenic Diet eBook. Click here to download it.

Now let’s consider dairy FATS:

High FAT dairy (e.g., butter or heavy whipping cream) has very little protein. You can reduce it further by clarifying your butter.

However, there is controversy surrounding another constituent found in dairy fats: “estrogen metabolites”. No studies involve dairy fat intakes as high as those typically associated with ketogenic diets. That further complicates this picture.

What it boils down to is this: all high-fat dairy, whether from industrial producers or happy cows on organic pastures, contains high levels of sex hormones. Hormone receptors in humans appear to bind to these. This can’t be a good thing in hormone-sensitive cancers! (These hormones are not related to the Bovine Growth Hormone controversy.) High-fat goat products contain significantly lower levels of hormones but finding high-fat goat products is challenging in the U.S.!

Many people express frustration at the amount of dairy included in most ketogenic recipes and meals.
Thankfully, dairy-free recipes are becoming more popular. Some Paleo sites also offer interesting dairy-free recipes.

Download Top Ketogenic Diet eBook. Click here to download it.

Dairy allergy vs. lactose intolerance:

There’s a difference between a dairy allergy and dairy intolerance.

  1. Dairy allergy involves sensitivity to a dairy protein (usually casein) that in turn provokes an immune system response.
  2. Lactose intolerance results from insufficient production of the enzyme needed to break down the linkage between the monosaccharides (glucose and galactose) that make up one molecule of lactose (“milk sugar”). If lactose can’t be broken down, it ferments in the gut, leading to bloating and diarrhea.

People with lactose intolerance often believe they can’t have ANY dairy products. However, high-fat dairy contains very little lactose! Even hard cheese, contains only small amounts of lactose so most lactose-intolerant people can tolerate condiment-sized amounts.

You might want to include higher carb choices- mainly kefir and yogurt- in your diet plan. Very limited amounts of these can be made more keto-friendly if you strain them first to remove the liquid whey.

Follow these steps:

  • Read the label. Choose only full-fat (whole milk) products with NO non-fat milk solids, sugars, starches, gums, or gelatins.
  • Place a strainer in a pot, line it with paper towels or cheesecloth, then empty the contents of the container into the strainer.
  • Set a plate on top and place a heavy can on it to weigh it down.
  • Leave overnight, discard the liquid, and refrigerate the solids.
  • Enjoy 2 tablespoons of the strained solids with a meal. Add a tablespoon of cream or some oil to boost the fat content.

Download Top Ketogenic Diet eBook. Click here to download it.