1/ Okay, this seems to keep coming up. People who are clearly very fat adapted (like, say, very athletic #LMHR #Carnivores), but who have lower ketones -- specifically, BHB (beta hydroxybutyrate) at perhaps 0.2 to 1.0
And they say, "Hey! Why aren't I in ketosis?"
Let's unpack..
And they say, "Hey! Why aren't I in ketosis?"
Let's unpack..
2/ Do we commonly see the athletes who are healthy on a mixed or even carb-centric diet with low levels of blood glucose? Yes, we do.
In fact, it's when we see high levels of fasting glucose in the blood *in spite* of being athletic that we start to worry, of course...
In fact, it's when we see high levels of fasting glucose in the blood *in spite* of being athletic that we start to worry, of course...
3/ ... We don't see an athlete with low glucose and assume they are not using as much of it as the couch potato with high glucose. Rather, it's likely the other way around.
In other words, accumulation in the bloodstream isn't a clear indication of use, it can mean the opposite!
In other words, accumulation in the bloodstream isn't a clear indication of use, it can mean the opposite!
4/ Like glucose, BHB is an energy substrate. Yes, we tend to have more of it detected in the bloodstream when we're fat adapted, but that doesn't equate to [more ketones] = [more fat adaptation].
In fact, it could even be the opposite. (Yes, I just said that)
In fact, it could even be the opposite. (Yes, I just said that)
5/ I've already done this several times in my own experiments when doing the protocol. If I have, say, a "fat shake" the evening before going to sleep, I'll wake up with higher BHB, which makes perfect sense to me. A blood test captures what is in transit, and **not yet in use**
6/ So can I set up an energy traffic jam in my blood? Sure. Even with BHB? Yep.
If you truly, completely want to be nearly 100% certain you are burning fat -- get a Respiratory Exchange Ratio test (RER or RQ). It's the gold standard to confirm actual cellular respiration ratio.
If you truly, completely want to be nearly 100% certain you are burning fat -- get a Respiratory Exchange Ratio test (RER or RQ). It's the gold standard to confirm actual cellular respiration ratio.
7/ Go ahead and put me on the record predicting #LMHRs who are truly ultra low carb will blow a super low RER, even if they are showing 0.3 BHB. Believe me, these people are running on fatty acids.
8/ For some time now I've hypothesized the reason for this difference is simply a greater relative shuttling of fatty acids for #LMHRs toward the VLDL-TG delivery pathway over ketogenesis. (Again, this is a marginal relative change, not an absolute one)
9/ Regardless, I continue to find the pursuit of super high serum ketone levels to be somewhat odd where there isn't a clinically specific reason to achieve it.
