Hello! I'm Courtney and I'm a health science writer and a Virtan. I read the studies done by Virta and others and thought I would write up an FAQ about ketones for all of us. It's a bit long - sorry! - but hopefully you'll all find it helpful. All answers below are based on information from Virta Health's website or recent scientific studies.
What are ketones?
Ketones are energy-rich molecules produced in your liver. Your liver is always making a few ketones, but when carbs are restricted and insulin levels are low, your liver makes even more - enough to supply 60-70% of your total energy needs. When you’re eating very few carbs, your body fat breaks down and is transported to your liver. Your liver releases the stored calories in your fat cells and makes ketones. Then it’s all sent out into your body to supply energy for your day.
In the mid-1800s, ketones were discovered in the urine of very sick patients with uncontrolled diabetes. This made people believe that ketones were a sign of sickness and metabolic dysfunction. This belief still persists today. But ketones are a natural substance produced by your body and studies show that they have many health benefits. Fun fact: even newborn babies use ketones for energy because breastmilk is a high-fat food.
What causes my ketones to fluctuate?
Studies show that ketone levels vary from person to person and from day to day. Everybody is different. You may be eating the same things as someone else, and they’ll have high ketone readings and you won’t. It’s not always a reflection of your diet. Many different things affect ketone levels, including:
-How many carbs you’re eating (watch those sneaky carbs)
-How much protein you’re eating (too much protein will increase your insulin levels. High insulin is the enemy of ketones.)
-The type of fat you’re eating: butter, coconut oil, and other foods with medium-chain triglycerides (MCT) can boost your ketone readings.
-Exercise: some people find that high-intensity exercise drops their ketone levels, while others find that exercise increases them. This is poorly understood and scientists are studying it now. If ketones drop after exercise, it’s a temporary drop and is most likely unimportant to long-term weight loss.
-Time of day: some people have high ketones in the morning, others have their highest readings right before bed. Try checking at different times to find when yours are the highest.
-Your genes. There’s a genetic component when it comes to how efficiently your body makes and uses ketones for energy. It’s poorly understood but is being studied right now.
-Your body chemistry. Every person is different and has different genes and varying amounts of things like enzymes and molecules that affect their metabolism. Your metabolism is a very complex group of chemical reactions and how it runs varies from person to person.
-Other things we don’t know yet. Studies on ketones are ongoing. We know a lot about them, but the human body is a complex machine and there is still more to learn! They’re still a bit of a mystery.
How do I increase my ketones?
The most obvious is to watch your carbs. You may be eating too many without realizing it. Some people are so insulin resistant that just 20 or 30 grams of carbs a day is too much.
Hidden carbs are sneaky. The food industry puts sugar in everything, from canned soups to ketchup to marinara sauce. Carbs are everywhere. They’re in some spices, sugar-free chewing gum, and even things like soy sauce and balsamic vinegar. Some vegetables are surprisingly high in carbs too, like onions and tomatoes. I personally had my weight loss stalled by using too many sugar substitutes. They may be sugar-free but they still have carbs.
If you are doing everything “right” and your ketones are still low, don’t stress. While it would be nice to see a high ketone reading as a payoff for all your hard work, ketones are still a bit of a mystery. Focus on other things, like your weight loss, your clothes fitting better, and sustained energy throughout the day. You may be genetically predisposed to lower ketone levels, but that doesn’t mean anything if you’re still losing weight and reversing diabetes.
Can I lose weight with low ketones?
Studies show you can still lose weight even if your ketone readings are low. Plenty of Virta Health patients lose their excess weight even though their ketones are often less than .5 mmol/L.
One theory is that your body may be so efficient at using ketones for energy that there isn’t much left over in the bloodstream or urine to show up on the monitor. This is just a theory and hasn’t been proven.
What are the benefits of using ketones as fuel?
Other than the obvious benefit of weight loss and blood sugar control, studies have shown that the ketogenic diet has many other surprising benefits. Recent and ongoing studies show that relying on ketones for energy:
-reduces inflammation in the body
-reduces oxidative stress, meaning less cell and tissue damage
-increases your body’s disease-fighting capabilities
-enhances your athletic performance because you’re not running out of carbs to burn
-improves mitochondrial function, meaning your body’s cells are working more efficiently
-improves DNA repair processes
-has heart-protective properties
-is associated with healthier gut bacteria (though this is not fully proven yet)
Can exogenous ketones help?
The short answer is probably not. The long answer: When you take ketones via a supplement, Virta Health scientists call this “chemical ketosis”. It is very different from nutritional ketosis. There are some problems with taking exogenous ketones, including:
-There haven’t been enough studies on exogenous ketones to safely prescribe an appropriate dose or schedule.
-Ketone salts may have a negative effect on your kidneys and blood PH balance.
-Ketone esters are associated with lower levels of body fat burning.
-Ketone supplements are not a natural balance of the different ketone types like they are in the body. One type of ketone breaks down in storage, so the supplements contain an imbalance of ketone types very different from what our bodies naturally produce. We don’t yet know if this is healthy or harmful.
-The supplements are made by chemists in a laboratory and have a different arrangement of atoms as compared to the natural ketones your body makes. The ketones your body naturally makes are easily used as fuel for your cells. Scientists are unsure if exogenous ketones, with their different chemical structures, can be used the same.
-Supplements are not regulated by the FDA like medications are. Supplements are regulated like food, meaning all you can be sure of is that the supplement is free from any germs. But there is no regulatory government body that checks to see if the bottle of supplements actually contains what it says it does or if the supplement does what they claim it does.
-Virta Health scientists think that taking exogenous ketones is unnecessary and can even reduce your own body’s ketone production.
-Taking ketone supplements doesn’t produce all the extra health benefits that you gain from producing your own ketones through a ketogenic diet.
-Some exogenous ketones, like raspberry ketones, are completely different molecules. They’re being sold as ketones, but they aren’t, and no study has ever shown any benefit to using them. The word “ketone” isn’t regulated, so any company can sell anything and call it a “ketone”.
Bottom line: Exogenous ketones can seem like a good thing when you see a high ketone reading on your monitor, but they haven’t been studied enough. Virta Health scientists say it’s best to reap the health benefits of natural ketones that your body makes as a result of a ketogenic diet. Don’t waste your money on poorly-regulated supplements.
Conclusion:
It’s easy to get frustrated when you feel you’re doing everything right and still not seeing good ketone readings. Ketones are fickle and not fully understood. Remember, they’re just an energy source, not a sign of accomplishment. Don’t get caught up in the numbers because they’re ever-changing. Instead of focusing on your ketone numbers, focus on these things:
-Do you have steady energy and concentration throughout the day?
-Are your hunger levels reduced?
-Do you have more energy?
-Are you losing body fat, even if it’s slowly?
-Are your clothes fitting better?
-Do you have steady blood sugar numbers?
-Are you coming off diabetes medications?
If you’re seeing and feeling the benefits of nutritional ketosis, then it doesn’t matter what the silly numbers on the device say! The numbers mean nothing if you’re seeing real-life benefits and results.
Sources:
Thank you Courtney for taking your time and education to enlighten us on ketones. It is very appreciated.
Mark
Ketone Mystery solved! Thank you for this great easy-to-understand article! I never have really understood so much about ketones, now I’m prepared for ketone battle! Ha!
Thank you for simplifying a difficult topic to understand, easier to comprehend! You have answered many questions I had about ketones.👏