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Very high ketones (darkest on the strips)

amanda_the_mom
amanda_the_mom Posts: 20 Member
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Hello,
I've been doing keto for a week and a half, and my urine ketones are super high - the highest that my strips measure - 16 mmol/L. It doesn't seem to matter how hydrated I am or what time of the day, they're always maxed out. I know It's not the strips because my husband is also doing keto and only getting 0.5 (trace amounts).

A bit of back story is that I did keto about 5 years ago and ended up in the hospital with ketoacidosis. However I am not diabetic, nor an alcoholic. I am not obese, but I am slightly overweight. But I was breastfeeding at the time, so the doctors said that must have been the extra glucose need for breastfeeding that led me into ketoacidosis.

I was getting the same high during ketones then as I am now, so I'm really worried that it could happen again. I've ordered a blood ketone tester so I can see what my blood ketone levels are, but it might be another week before it arrives. I had fruit today and last week to try and bring down my ketones. On top of it I really haven't lost any weight (0.4 lbs in about 1.5 weeks). I haven't been tracking in mfp but I've tracked enough in my lifetime that I'm certain that I'm not overeating. Today, I only had 4 deviled eggs (so 2 eggs worth) 2 kiwis, about 4 ribs and some roasted cauliflower and broccoli with butter. I was too full to eat any more.

Does anyone know why my ketones could be so high? Also, I feel like I must be utilizing most of them because I feel awesome and full of energy!

Replies

  • kpk54
    kpk54 Posts: 4,474 Member
    edited January 2018
    Sunny_Bunny_ wrote: »
    If you are not T1D you did not have ketoacidosis. It’s impossible.
    You were misdiagnosed by doctors that don’t understand nutritional ketosis because you had ketones present. You were probably severely sodium deficient if you weren’t supplementing sodium of 5000-7000mg a day every single day. That can cause metabolic acidosis but it is absolutely nothing like ketoacidosis.
    Trust me. My daughter has spent too many days in ICU with that.

    Your urine ketones are high because you’re not utilizing them. That’s fine. Your body is peeing out unused calories.
    I always had very dark strips too. Though I did do a test to force them to be lighter by drinking lots of coffee until I was peeing about once every 30-45 minutes. The diuretic effect of that reduced the concentration in my urine.

    Your body pees out calories or did you mean ketones?
  • KnitOrMiss
    KnitOrMiss Posts: 10,103 Member
    @amanda_the_mom

    Please share with us your symptoms aside from the dark urine strips that are concerning you, as well as what symptoms landed you in the hospital before... More information on the symptoms themselves might help others to give perspective or more insight on anything at play...

    I agree with the above post that this is more likely an electrolyte imbalance combined with dehydration causing organ issues (kidneys, especially, get really messed up when you're dehydrated)...

    And to me, it seems very likely that if you're eating kiwis and fruit to "break your level of ketosis" and IT'S NOT HELPING AT ALL, then that is very unlikely to be the issue at hand...or at the very least, not the ONLY issue.
  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
    edited January 2018
    kpk54 wrote: »
    Sunny_Bunny_ wrote: »
    If you are not T1D you did not have ketoacidosis. It’s impossible.
    You were misdiagnosed by doctors that don’t understand nutritional ketosis because you had ketones present. You were probably severely sodium deficient if you weren’t supplementing sodium of 5000-7000mg a day every single day. That can cause metabolic acidosis but it is absolutely nothing like ketoacidosis.
    Trust me. My daughter has spent too many days in ICU with that.

    Your urine ketones are high because you’re not utilizing them. That’s fine. Your body is peeing out unused calories.
    I always had very dark strips too. Though I did do a test to force them to be lighter by drinking lots of coffee until I was peeing about once every 30-45 minutes. The diuretic effect of that reduced the concentration in my urine.

    Your body pees out calories or did you mean ketones?

    Ketones are energy. Calories are energy. It’s broken down into ketones to be used as fuel and then not used so it’s eliminated.
    So essentially yes. Why wouldn’t it be calories?
  • kim_m_kk
    kim_m_kk Posts: 61 Member
    You do not have to have type 1 to have dka. Please don’t tell people that. There are lots of crazy scenarios that can lead to dka. I just had one occur and I am type 2. I even have well controlled blood glucose levels. Mine was a combo of the drug Jardiance and a Keto diet.
  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
    kim_m_kk wrote: »
    You do not have to have type 1 to have dka. Please don’t tell people that. There are lots of crazy scenarios that can lead to dka. I just had one occur and I am type 2. I even have well controlled blood glucose levels. Mine was a combo of the drug Jardiance and a Keto diet.

    Then you were misdiagnosed
  • KnitOrMiss
    KnitOrMiss Posts: 10,103 Member
    It's actually quite scary to know that medications can trigger a situation of DKA. I would expect that anything that messes with the pancreas could artificially create a DKA situation, since NOT PRODUCING INSULIN AT ALL is the main aspect that causes it. So any medications that reduce or inadvertently stop the pancreas from producing insulin could create the situation in which DKA could occur, even if it is considered a variation upon DKA that occurs with T1D (or LADA)...
  • ccrdragon
    ccrdragon Posts: 3,374 Member
    Ketoacidosis is one of the listed side-effects of Jardiance. I am not sure what the mechanism would be, but it is listed. Not sure how it would work since Jardiance is supposed to decrease blood-sugar which would not be done by decreasing insulin production. I would think that decreasing insulin production would increase blood glucose levels and not decrease them.

    But, back to the original topic, DKA is caused by high BG levels at the same time as high ketone levels - either one without the other does not result in DKA. High ketones and low glucose is the desired result of either low-carb or keto dieting.
  • MySweetLavinia
    MySweetLavinia Posts: 90 Member
    Sunny_Bunny_ wrote: »
    If you are not T1D you did not have ketoacidosis. It’s impossible.

    This isn't true, there are scientifically studied cases (though rare) of non-diabetic, breastfeeding women developing ketoacidosis. It is specifically called lactation ketoacidosis. There is a lot more that goes into diagnosing this than "patient has ketones in her blood", including serum pH and anion gap values.

  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
    MySweetLavinia wrote: »
    Sunny_Bunny_ wrote: »
    If you are not T1D you did not have ketoacidosis. It’s impossible.

    This isn't true, there are scientifically studied cases (though rare) of non-diabetic, breastfeeding women developing ketoacidosis. It is specifically called lactation ketoacidosis. There is a lot more that goes into diagnosing this than "patient has ketones in her blood", including serum pH and anion gap values.

    All I’m saying is I am aware of people being diagnosed simply due to metabolic acidosis and present ketones.
    These things are still not the same as ketoacidosis.
    I am more than aware of the anion gap, blood gas values, ph, magnesium, phosphorus, potassium, and every other blood test that is conducted every 4 hours around the clock when a person is indeed in DKA.
    Anyone can become acidotic through severe dehydration. Anyone can have ketones. I’m only saying the specific diagnosis is being mistakenly called ketoacidosis because of the presence of ketones. If it were the same situation without ketones, they would simply call it metabolic acidosis. Even if all the other bloodwork were the same. Doctors will call it ketoacidosis if even very small amounts of ketones are present.
    But it’s not the same thing. Nowhere near.
  • kim_m_kk
    kim_m_kk Posts: 61 Member
    I had DKA and the anion gap and a ph and blood tests performed ever four hours around the clock. I did have dka with all the lab work to prove it. I don’t know why you would think you know my story better than me. There are unusual cases. I am one of those. The drs agreed that it didn’t make sense but it still was. Telling people it can’t happen could leave someone at risk.
  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
    kim_m_kk wrote: »
    I had DKA and the anion gap and a ph and blood tests performed ever four hours around the clock. I did have dka with all the lab work to prove it. I don’t know why you would think you know my story better than me. There are unusual cases. I am one of those. The drs agreed that it didn’t make sense but it still was. Telling people it can’t happen could leave someone at risk.

    All I am saying is that metabolic acidosis with ketones is different than DKA.
    I NEVER SAID IT WASN’T SERIOUS.
  • kim_m_kk
    kim_m_kk Posts: 61 Member
    The only difference is that I didn't have high glucose levels -
  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,140 Member
    kim_m_kk wrote: »
    The only difference is that I didn't have high glucose levels -

    And that’s because you had adequate insulin which prevents ketoacidosis but not metabolic acidosis which has some similar identifiers.
  • kim_m_kk
    kim_m_kk Posts: 61 Member
    OMG just stop - I didn't have high blood sugar numbers because I was on medication for Diabetes and controlling my sugar. All of the DRs that I have seen have said DKA that happened because of the Jaridance. (there is even a class action law suit about this) but I guess Dr Sunny Bunny knows all.
  • KnitOrMiss
    KnitOrMiss Posts: 10,103 Member
    edited February 2018
    @kim_m_kk

    I will say that there are vetted articles stating both cases - that it cannot be DKA in absence of less than a number of 250 for blood sugar -- and also that there are some that say that it can be DKA with relatively normal blood glucose numbers, but only in the presence of illness or injury, and even then, with exceptional rarity.

    I read a number of articles on Jardiance as well, and many doctors in those articles are using the terms Metabolic Acidosis and Diabetic Ketoacidosis interchangeably, which we know those two things are not the same.

    The articles that seemed the most reliable seemed to indicate that Jardiance generates a type of Metabolic Acidosis that is an artificial type of DKA.

    Personally, I don't know.

    I do know that DKA in a Type 1 person whose body can't fight back in any way is severe enough that in hours they person can be dead and/or that it can take weeks to months to get anywhere near level again. I am quite thankful that this is not what happened to you.

    Since the doctors across the medical field cannot agree, here, too, we shall agree to disagree.



    ALL:
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