Blood Chemistry – Part 2

The ketogenic diet is a measurable chemistry equation, which means that your blood chemistry can reveal whether you are in ketosis or not. Measure your blood ketones to prove to yourself as to what is happening in your bloodstream. Glucose or ketones, both fuels used by your body, can be measured. Depending on which fuel is available in your bloodstream will determine what your cells’ mitochondria are burning for energy.

Glucose burners burn glucose for fuel. All body cells, tissues and organs can use glucose, but too much glucose can lead to disease states like Type 2 Diabetes, Alzheimer’s or other diseases of inflammation. Using a glucometer, glucose levels can be measured in your blood.

Ketone burners use ketones and free fatty acids to fuel most cells, tissues and organs. Using ketone strips (blood or urine) or ketone breath meters like Biosense, you can determine whether you are successfully in ketosis.

If you read “Blood Chemistry Part 1” then you may recall that I emphasized that “keto” is more than a label for a diet, but the chemistry of making ketones in your liver and releases them into your blood for fuel/energy. You may follow a keto food list and tracking how many carbs you intake

Keto is short for ketosis. And ketosis is the chemistry of making ketones by your liver for cellular and organ fuel. The keto diet is really a way of eating that enables your body to make ketones for fuel and relies less on glucose to fuel. When I first looked into this way of eating it was referred to a well-formulated ketogenic diet (WFKD). Sometimes you may hear nutritional ketosis used too. This term is used to differentiate producing ketones intentionally for fuel rather than ketoacidosis which is a state where both glucose and ketones are excessively high. Ketoacidosis is a medical emergency and is associated with Type 1 Diabetes.

Chase results NOT ketone numbers.

Craig Emmerich, author of keto

After reading Dr Boz’s book, Any Way You Can, I wanted to know whether I was actually making ketones or not. I’d stopped measuring with ketone monitors of any kind by this stage of my keto journey. For the most part, I used symptoms to “inform” me whether I was in ketosis or not (see Blood Chemistry Part 1 for a list of symptoms). It was time to see if I truly was “keto-adapted” or not. My analytical mind needed real numbers to see how measurable ketosis truly was.

I decided to do my experiment during December and New Year’s. I know, crazy right! To further complicate this experiment, I contracted COVID and was diagnosed with bacterial and COVID pneumonias on day 9. Being in ketosis simplified things though — reduced cravings and the ability to fast when I didn’t feel like eating because I was sick.

Experiment Parameters

  • track with Cronometer
  • use an Excel spreadsheet to track all numbers being recorded
  • keep total carbs to 20 grams
  • protein grams as a maximum — calculated using this macro calculator
  • fat grams were consumed until satiety
  • added 1 scoop MCT powder to first morning coffee (first couple of weeks until ketones were consistent)


When I first ketone blood and breath readings were zero — that’s right, no ketones! Not very encouraging when you think you were eating keto foods and recipes from keto cookbooks, occasionally tracking macros and moving your body. Those results were a complete surprise to mean it did make me rethink whether symptoms were a good way to determine when myself or my clients were in ketosis or not.

Time to be diligent in tracking my carbs and keeping them to 20 grams using the Cronometer app. I kept my protein and fats where they had been — protein around 85-100 g and enough fat to satisfy and produce hormones (above 40g). To start making ketones, I included MCT in morning coffee until I “peed pink” as recommended by Dr Boz . I knew my liver was producing too ketones because I was dumping ketones. I maintained adding “fat” to my morning coffee for about 6 weeks before I cleaned up my morning drink — no added fats or sugars.

The dumped ketones increased initially until my liver figured out my body’s needs. My blood ketones didn’t get higher than 3.0 mmol/L. My breath ketones rose as more cells and organs using ketones successfully used ketones for fuel. This was more evidence of ketones being used as fuel as expelled through my breath. Last to join the ketone party was my brain — this transition took longer because increased inflammation from having COVID and bacterial pneumonias needed resolution. The need for increased healing resulted in higher ketones being used & expelled.

Initially I checked out the ketogenic diet because I wanted to keep my genetic predisposition to Alzheimer’s at bay. So my goal with my keto lifestyle has been and continues to be to create ketones for cognitive support and any brain decline due to inflammation and/or Alzheimer’s.

I experienced the added benefits of fat loss, inches lost, reduced inflammation, increased mental alertness, improved sleep, less monkey mind at night (ketones increase GABA), increased physical energy, and accelerated healing from the pneumonia lung damage. Additionally, my blood pressure lower and was the best it had been in a long time. All good signs of improved mitochondrial health and using clean burning ketones for fuel. I felt amazing!

Ways to Measure Ketones

The beauty of the ketogenic diet is that it is measurable. Remember what I said initially keto is not a diet but the chemistry in your blood.

Urine ketone strips are the easiest and least expensive way to measure if you’re making ketones. The problem is that this tool measures what you are dumping and not using for fuel. However, I have found that my clients like knowing that they are making ketones and this method works. I recommend purchasing a bottle of strips and then use them a couple times a day initially. But finish the bottle of strips before deciding whether to move onto a ketone blood meter.

Ketone blood meters are the “gold standard” of ketone measuring. If you like data and to know how much “fuel” is in your bloodstream, this is the way to go. I use both ketone and glucose strips — they give me an indication of how much of these two fuels are available. If my glucose numbers are low, then I’ve kept my carbs low enough, which in theory means my insulin is low too. If my ketone numbers are above 0.5 mmol/L, I am in ketosis. Easy.

Ketone breath meter is gaining popularity because you don’t have to prick your finger and draw a drop of blood to measure on a strip. I’ve tried a number of ketone breath devices and some are more expensive than others. I started using Biosense in late 2021 and I like the simplicity of using it. I also like how I analyze whether I am using ketones as fuel.

Take Aways

  • Ketones burn cleanly and most cells know how to use ketones for fuel
  • 20% of your brain, the centre of your kidneys, a part of your retina and your red blood cells require glucose
  • Your body is able to “make” glucose to feed these organs and tissue by a process called gluconeogenesis.
  • Nutritional ketosis is all about your blood chemistry –> Are you making ketones and using them?
  • The ketogenic diet is measurable
  • You can follow a consistent keto diet for a lifetime

“Improve your health, one ketone at a time.

Dr Annette Bosworth, AKA Dr Boz

Let’s Chat

Can’t wait to know how these ketone measuring tools can change your keto journey? Or maybe you need to tweak your current keto protocol because you’re in a plateau or stalled. Perhaps you are simply curious about following a well-formulated ketogenic diet. Don’t wait! Send Brenda an email to schedule your FREE Discovery Chat to find out to take your keto journey to the next level.

About Brenda

Brenda loves learning and sharing what she's learning with you. She is a certified keto/carnivore coach with Keto-Adapted (Maria and Craig Emmerich, a certified holistic nutritional consultant (CHNC), and a natural nutrition clinical practitioner (NNCP).