What is ketosis?
Ketosis is a metabolic state where your body switches from using glucose as its main source of energy to using ketones. This happens when you restrict your carbohydrate intake to low levels, typically less than 50 grams per day. The reduction in carbs puts your body in a metabolic state called ketosis.
When in ketosis, your liver begins producing high numbers of ketones to supply energy for your brain. Ketones are produced when your liver breaks down fats. Your body enters ketosis when blood ketone levels reach 0.5-3.0 mmol/L.
Being in ketosis allows your body to tap into your fat stores for energy. This means you can lose weight by following a ketogenic diet. Plus, ketosis has been linked to other health benefits as well, such as improved cognitive function.
Signs and symptoms of ketosis
You may experience some signs and symptoms when you first enter ketosis. These usually go away after a few weeks once your body adapts to using ketones and fats for fuel. Here are some of the most common signs you’re in ketosis:
Bad breath
One of the top signs of ketosis is bad or fruity smelling breath. Acetone is one of the ketone bodies produced in ketosis. A small amount is excreted when you breathe out, causing a fruity odor.
Drinking water and using breath mints or mouthwash can help mask keto breath until your body adapts.
Increased urination and thirst
When your carb intake is very low, your kidneys excrete excess ketones and sodium through urine. This leads to increased urination.
It’s important to stay hydrated while in ketosis by drinking plenty of water. Increased thirst is your body’s way of telling you it needs more fluids.
GI issues
Making a drastic change to your diet can sometimes cause temporary digestive issues like constipation, diarrhea or nausea. This should improve within a few weeks as your digestive system adapts.
Lack of energy and mental fog
Some people feel tired, sluggish or experience brain fog when transitioning into ketosis. Your body needs time to adapt to using ketones instead of carbs for fuel, causing temporary fatigue.
This “keto flu” usually lasts a day or two. Making sure you’re getting enough electrolytes can help counter these symptoms.
Trouble sleeping
It’s common to experience insomnia or disrupted sleep patterns when switching into ketosis. Some of the potential causes include electrolyte imbalances, low blood sugar levels overnight or your brain getting used to lower carb intake.
These issues typically resolve within a few weeks as your body adapts to being in ketosis.
Reduced exercise performance
You might notice weaker exercise performance when you first start a keto diet. Your body needs time to get used to utilizing fat and ketones instead of carbs for fuel during exercise.
Performance should improve again after a few weeks in ketosis. Some athletes even report increased endurance after keto-adapting.
Sugar cravings
It’s normal to experience intense sugar and carb cravings when transitioning into ketosis. Your body is used to relying on carbs for energy and needs time to adapt to burning fats and ketones instead.
The cravings should dissipate within a week or two as your body adjusts to the new fuel source.
Weight loss
Weight loss often occurs quickly when entering ketosis due to decreasing carb intake and losing excess water weight. You can expect rapid weight loss in the first week or two.
After that, a reasonable goal is 1-2 pounds per week on keto. Less drastic losses indicate fat loss rather than water weight.
How to tell if you’re in ketosis
Wondering definitively if you’re in ketosis? Here are some ways to check:
Test urine ketone levels
There are several types of ketone urine test strips you can use. These measure acetoacetate ketone levels in your urine. A positive result indicates you’ve entered ketosis.
Urine tests are affordable and easy to use. However, they can be inaccurate once your body adapts to ketosis and aren’t a reliable long-term gauge.
Measure blood ketone levels
You can use a blood ketone meter to test levels of beta-hydroxybutyrate ketones in your blood for the most accurate results. Blood ketone levels over 0.5 mmol/L indicate you’re in ketosis.
Blood meters are more expensive than urine strips but give you a precise ketone measurement. They’re the most reliable way to monitor ketone levels long-term.
Try the breath acetone test
The breath acetone test measures acetone levels in your breath, which correlate to ketone levels in your blood. Handheld breath analyzers can detect acetone above a certain threshold, signaling ketosis.
This method is non-invasive but can be less accurate than blood meters since acetone levels fluctuate. Breath meters are more expensive than urine strips as well.
Track carb intake
Keeping net carbs under 50 grams daily typically induces ketosis in most people. You can also track your macro ratios, aiming for 70-80% fat, 15-25% protein and 5-10% carbs from your total calories.
Tracking macros and weighing your food ensures you’re eating at carbohydrate levels low enough to promote ketosis.
Notice signs and symptoms
While subjective, taking note of common symptoms like bad breath, increased urination and thirst, or keto flu can provide clues you’ve entered ketosis.
However, not everyone experiences these signs. The only way to know definitively is to test ketones.
Optimal ketone levels
Once you’re in ketosis, you may be wondering what ketone levels to aim for.
Here are general guidelines based on testing method:
Urine ketones:
– Trace ketones: You’re approaching ketosis
– Small/moderate ketones: You’re in ketosis
– Large ketones: Your body has excess unused ketones
Blood ketones:
– Under 0.5 mmol/L: Not in ketosis
– 0.5-3.0 mmol/L: Nutritional ketosis zone
– Over 3.0 mmol/L: Possible ketoacidosis (rare, occurs mostly in diabetes)
Higher blood ketone levels don’t necessarily equal faster weight loss. Focus on keeping levels in the 0.5-3.0 range for optimal ketosis.
Tips for entering and staying in ketosis
Here are some tips to get into ketosis quickly and stay there:
– Restrict net carbs to 20-50 grams per day
– Calculate your macros and track your food intake
– Limit protein intake to moderate levels
– Eat plenty of high-fat foods like oils, butter, nuts and seeds
– Drink water and mineral-rich broths to replenish electrolytes
– Exercise regularly to deplete carb stores
– Try intermittent fasting like 16:8 or the 5:2 diet
– Get enough sleep and manage stress levels
– Test ketones to ensure you’re in optimal ranges
– Avoid temptation and plan low-carb meals and snacks
Foods to eat on a ketogenic diet
Here are some of the best keto-friendly foods to enjoy:
Meats:
Beef, chicken, pork, bacon, sausage, lamb, etc.
Fish and seafood:
Salmon, trout, tuna, sardines, mackerel, shrimp, scallops, etc.
Eggs
Non-starchy vegetables:
Leafy greens, broccoli, cauliflower, zucchini, peppers, mushrooms, etc.
High-fat dairy:
Butter, hard cheeses, heavy cream, plain Greek yogurt
Nuts and seeds:
Almonds, walnuts, macadamia nuts, pumpkin seeds, etc.
Avocados and olive oil
Berries:
In moderation
Herbs, spices and condiments:
Salt, pepper, mustard, salsa, etc.
Foods to avoid on keto
Steer clear of these high-carb foods:
Grains:
Bread, pasta, rice, cereals, etc.
Starchy vegetables:
Potatoes, sweet potatoes, peas, corn, etc.
Legumes:
Beans, lentils, chickpeas, etc.
Sugary foods:
Candy, soda, cake, ice cream, etc.
Fruit:
Bananas, apples, oranges, grapes, mangoes, etc.
Low-fat products:
Often high in added sugars
Beer and sweetened drinks:
Opt for low-carb options
Processed meals:
Noodles, pizza, burgers, tacos, etc.
Should you test for ketosis?
Testing your ketone levels is optional but can be a useful tool, especially when first starting out on a ketogenic diet.
Here are some pros of testing for ketones:
– Confirms you’ve achieved ketosis
– Provides feedback to help adjust your diet
– Motivating to see high ketone levels
– Helps troubleshoot plateaus or low energy
And some potential cons:
– Testing isn’t mandatory
– Can be expensive if using blood meters long-term
– Anxiety causing if overly focused on readings
– Changes in levels are hard to interpret
Try using urine test strips at first. If you want to track ketosis long-term, invest in a reliable blood ketone meter. Don’t let testing become obsessive. Listen to your body and adjust carbs based on your goals.
Troubleshooting ketosis challenges
Having trouble entering or staying in ketosis? Here are some tips if you’re experiencing:
Symptoms of keto flu:
– Drink more water and broth
– Make sure you’re getting enough sodium, magnesium and potassium
– Try MCT oil or exogenous ketones
– Eat more fat to give your body energy
– Reduce exercise temporarily
Lack of weight loss:
– Double check you’re tracking carbs accurately
– Be patient – stalls are normal
– Try intermittent fasting or carb cycling
– Check for hidden carb sources
– Rule out medical conditions
– Reassess calorie intake
Low ketone levels:
– Lower your carb intake further
– Check protein isn’t too high
– Add more high-fat foods and MCT oil
– Try a fat fast for 1-3 days
– Exercise to deplete glycogen stores
Gut issues:
– Drink more water and eat more fiber
– Try probiotic foods
– Slowly transition into keto
– Check for food sensitivities
Strong carb cravings:
– Make sure you’re eating enough calories and fat
– Manage stress and get enough sleep
– Distract yourself and delay cravings
– Add more salt to your diet
– Try keto-friendly sweeteners if needed
Conclusion
Achieving ketosis provides powerful health and weight loss benefits, but isn’t always straightforward. Look for typical signs like increased urination, temporary flu-like symptoms, or keto breath within your first 1-2 weeks on the diet. Testing ketones in your urine or blood provides validation you’ve reached ketosis. Aim for levels between 0.5-3.0 mmol/L in your blood for optimal ketone ranges. Adjust your carbohydrate and protein intake to troubleshoot challenges and stay in ketosis long-term. With persistence and patience, staying in nutritional ketosis can become easy and sustainable.
