Doing keto for weight loss, especially for someone with significant weight to lose, can be a straightforward affair: restrict carbs below 50 grams, and it’s likely that you will often be in some form of nutritional ketosis no matter what your fat-to-protein ratio is. Doing keto for medical purposes, notably epilepsy and other neurological or psychiatric conditions, requires far closer monitoring of ketone levels.
What does it feel like when ketone levels drop? When clients are looking for benefits beyond weight loss and are working with a medical team, we often look for people to be in the 1.5-3.5 mmol/L range. Some people who experience a reduction in symptoms at the 3+ mmol/L range will experience immediate irritability, low energy, or emotional changes when they dip below this. Other people feel best in the 1-2 mmol/L range- it is a very individual process.
If you have access to a blood ketone meter, which is the most accurate way to measure at home, you can establish for yourself what levels feel best to you.
Until you nail down the levels that work for you and how to consistently stay in that range, it can be stressful to see the ketone fluctuations that happen throughout the day. Ketones are typically lower in the morning, dip after meals, and can rise and fall for a whole host of complicated physiological reasons.
It is important to remember that many of these fluctuations are beyond your control, while some are in partially conscious control (such as stress levels). If your ketone levels bounce around, don’t panic!
Regular dieting can be an emotional rollercoaster for people who live and die by the number on the scale- which can definitely fluctuate by multiple pounds. Keto dieting can add another dimension of fluctuation with ketone levels, so it is very important to keep a sense of calm and perspective. Ketone levels will fluctuate for all sorts of reasons, but the important thing is to stick with your meal plan, continue taking enough readings to adjust macros, and then letting go of worry.
Since stress releases cortisol, and high cortisol can increase blood sugar (and perhaps drop ketones, which requires more research before we can say for sure), one of the best things you can do when embarking on a new way of eating is to engage in practices that make you feel centered and peaceful. Walking in nature, meditating, spending time with close friends, and other stress reduction methods all support your body in making any big changes.
Ketosis can be an emotional rollercoaster, but the benefits hopefully make the wild ride worth it. The bright side is that many people feel a distinct sense of calm when ketones are adequately high, so sticking with your diet carefully is your best bet for arriving at your preferred destination.