Keto And Lab Work: What You Need To Know

The ketogenic diet is a low-carb, high-fat diet that can be an effective way to lose weight and improve health. While it is generally safe, there are some potential side effects and certain individuals may need to take precautions.

Before starting a keto diet, it is important to consult with a healthcare provider, especially if you are taking medications for diabetes or high blood pressure. It is also recommended to get a fresh start by cleaning out your fridge, freezer, and pantry, and planning your meals ahead of time.

There are several blood tests that can be done to monitor your health while on a keto diet. These include checking your blood sugar levels, cholesterol levels, thyroid hormones, and vitamin levels. Regular monitoring can help ensure that your diet is not having any negative effects on your body.

Monitor blood sugar levels

Monitoring your blood sugar levels is important to ensure your body is functioning well and to lower your risk of diabetes and heart disease. Blood sugar levels that are higher than normal can cause damage to the body. Blood glucose is the amount of sugar circulating in your blood. When you eat food, your blood sugar will rise and fall, and how high your blood sugar spikes depends on the food you eat. A high-carb meal will cause a bigger spike than a low-carb, high-fat meal.

How to Monitor Blood Sugar Levels

You can monitor your blood sugar levels with a blood glucose monitor. These are easy to find and relatively affordable. You can also use a continuous glucose monitor (CGM), an FDA-approved tool that takes readings of your glucose levels every fifteen minutes.

Optimal Blood Sugar Levels

According to the Mayo Clinic, a fasting blood sugar level under 100 milligrams per deciliter is healthy. Your blood sugar following food should not exceed 125 milligrams per deciliter, as this is a sign of prediabetes.

Factors that Impact Blood Sugar Readings

Many factors can impact your blood sugar readings, including non-caloric sweeteners, lack of exercise, and alcohol.

Benefits of Monitoring Blood Sugar on Keto

Monitoring your blood sugar on keto can give you insights into how your body responds to specific foods, help you understand what spikes your blood sugar, and provide evidence of change when starting out on a new diet.

Check cholesterol levels

Checking your cholesterol levels is crucial if you're on a keto diet, as a high-fat diet can pose serious health risks that aren't always visible.

Cholesterol is a waxy, fat-like substance that is essential for the normal functioning of cells in the body. However, too much cholesterol can increase health risks. When cholesterol levels are too high, it can build up or form deposits in the arteries, increasing the risk of a heart attack or stroke.

There are two ways to check your cholesterol levels: with an at-home test kit or through standard blood work by a medical professional.

At-Home Cholesterol Test Kits

At-home cholesterol test kits are a convenient and effective way to monitor your cholesterol levels without visiting a doctor's office. They are usually priced under $20 and can be purchased at your local pharmacy or medical supply store. The standard kit contains a lancet for drawing blood and test strips.

Here's how to use an at-home cholesterol test kit:

• Prick your finger with the lancet to draw a drop of blood.
• Place the blood droplet on the test strip.
• The test strip has special chemicals that change colour after a few minutes.
• Match the final colour against a colour guide provided with the kit to determine your cholesterol level.

Some newer test kits have an electronic meter that functions similarly to a diabetes blood glucose meter. The test strips are inserted into the device, and a small computer automatically measures your cholesterol level.

While at-home test kits are convenient, they should not replace the assessment of a healthcare provider. These kits provide an estimate of your cholesterol level and should be used in conjunction with medical advice and testing.

Standard Blood Work by a Medical Professional

For a more comprehensive understanding of your cholesterol levels, it is recommended to get a complete lipid panel through standard blood work. This test measures total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides.

Before the test, it is recommended to fast for 12 hours, as eating can cause fluctuations in triglyceride levels. The test involves drawing blood, usually from a vein, and sending it to a laboratory for analysis.

Recommended Testing Frequency

The frequency of cholesterol testing depends on your individual circumstances. According to the American Heart Association, adults over the age of 20 with low-risk factors should check their cholesterol about every 4-6 years. For people at higher risk of heart disease or those already diagnosed, a doctor may recommend more frequent testing.

Understanding Cholesterol Levels

Cholesterol levels are reported in milligrams per decilitre of blood (mg/dL). Here are the common target levels for different types of cholesterol:

• Total cholesterol: Under 200 mg/dL
• HDL (good) cholesterol: Above 60 mg/dL
• LDL (bad) cholesterol: Below 100 mg/dL
• Triglycerides: Below 150 mg/dL

It is important to interpret cholesterol test results in the context of your overall health, including age, sex, risk factors, and health history.

Managing High Cholesterol

If your cholesterol levels are outside the desired ranges, it is important to consult a healthcare professional. They can recommend lifestyle changes and medications to help manage and lower high cholesterol. Recommended lifestyle changes include maintaining a moderate weight through a balanced diet and regular exercise, avoiding tobacco products, and reducing alcohol consumption.

Monitor thyroid hormones

Thyroid hormones play a critical role in regulating metabolism and other essential body functions, such as heart rate, metabolism, and fertility. Thyroxine (T4) and triiodothyronine (T3) are the primary hormones produced by the thyroid gland. T4 is the inactive form, while T3 is the active form of the thyroid hormone. The thyroid gland produces these hormones, which are then converted into their active forms by the liver.

When following a keto diet, it is important to monitor your thyroid hormone levels, especially if you have an underlying thyroid condition. Eating too few carbohydrates can lower thyroid hormone levels, which may cause issues if your baseline levels are already low. For example, low T3 and T4 levels can lead to fatigue, constipation, and weight gain.

To ensure the keto diet is not exacerbating any underlying thyroid issues, it is recommended to check your T3, T4, and Thyroid-Stimulating Hormone (TSH) levels. TSH is produced by the pituitary gland and stimulates the thyroid to produce T3 and T4. Monitoring TSH levels is crucial because even if T3 and T4 levels decrease, TSH levels may remain stable, indicating that the body is adapting to dietary changes and maintaining a healthy metabolic rate.

Additionally, it is important to distinguish between the effects of the keto diet on thyroid hormone levels and actual thyroid function. While T4 levels may decrease on a keto diet, this does not necessarily indicate a decline in thyroid health or metabolism. Studies have shown that keto and low-carb diets do not negatively affect thyroid health, even for athletes and overweight individuals.

If you are considering a keto diet, consult your healthcare team, especially if you have thyroid issues. They can advise you on how to safely follow the keto diet while monitoring your thyroid health. Regular thyroid testing is essential to spot any hormone changes early and allow for prompt action if needed.

Measure ketones

Measuring Ketones

Ketosis is the process of burning body fat for energy and can be measured when following a low-carb ketogenic diet. While it is not necessary to test for ketones for the diet to work, some people may find it helpful to check they are on track and tailor their diet for more effective weight loss.

There are a few different methods for measuring ketones, each with pros and cons.

Urine Testing Strips

These are cheap and convenient, but less accurate than other methods as they measure ketones in the urine rather than the breath or blood. The results reflect ketone levels over the past few hours, rather than at the time of testing. However, they are good for a rough idea of the level of ketosis.

Blood Ketone Tests

Blood tests are the most accurate method of measuring ketone levels but the cost of the test strips is relatively expensive if you intend to test regularly. These tests can be performed using certain blood glucose meters that have been specifically designed to test for ketones.

Breathalyser

It is possible to measure ketones on the breath. This method is not as accurate as blood ketone tests but is better than urine test strips. A breathalyser involves a single upfront cost, meaning you can test your ketone levels as often as you like. This can be useful for people who want to understand how well they are achieving ketosis throughout the day.

When to Measure Ketones

When and how often you test ketones will depend on what you are looking to find out. If you want to compare whether you are keeping in ketosis from day to day or week to week, then it makes sense to test at the same time of day to ensure consistent results. As ketones vary throughout the day and are affected by different types of meals and exercise, you may want to test at different times to see how your level of ketosis varies.

The sweet spot for weight loss is 1.5 to 3.0 mmol/l. This level of nutritional ketosis is recommended by researchers Stephen Phinney and Jeff Volek. Ketone levels of 0.5 to 1.5 mmol/l, light nutritional ketosis, is also beneficial, although not to the same degree as full nutritional ketosis.

The longer you stay within these levels, the more fat you will burn and the more effective your weight loss efforts will be.

How to Achieve Higher Ketone Levels

Many people who believe they are eating a strict low-carb diet are surprised when they measure their blood ketones. The trick is to avoid all obvious sources of carbohydrates, consider time-restricted eating, and use fat as a lever for taste and satiety.

Sometimes adding MCT oil to your coffee or tea can help increase your ketone levels.

Important Considerations

If you have type 1 diabetes, you should not follow the above advice to purposefully increase your ketone levels – it may be risky. If you have ketones in your blood, you must be sure that your blood sugar levels are normal. If they are not, you may be at risk of ketoacidosis – a potentially life-threatening condition.

Monitor liver function

Monitoring liver function is crucial when following a keto diet to ensure that your 'healthy' diet is not inadvertently causing damage to your body. Here are some detailed instructions on how to monitor your liver function while on a keto diet:

• Understand the risks: The keto diet is a high-fat, low-carb diet that can lead to weight loss and improved glycemic control. However, it also carries the risk of increasing blood cholesterol levels and elevating liver enzymes, which can lead to potential non-alcoholic fatty liver disease (NAFLD).
• Get baseline liver function tests: Before starting the keto diet, it is essential to get baseline liver function tests, including alanine aminotransferase (ALT) and aspartate aminotransferase (AST) tests. These tests will provide a reference point to compare future test results and help detect any changes in liver function.
• Monitor liver enzymes regularly: While on the keto diet, regularly monitor your liver enzymes, such as ALT and AST. Elevated levels of these enzymes can indicate potential liver damage. If you notice a significant increase in these enzymes, consult with a healthcare professional.
• Be cautious with certain medications: If you are taking medications for diabetes or hypertension, consult your doctor before starting the keto diet. The keto diet can lower blood sugar and blood pressure, and medication doses may need adjustment to prevent excessively low levels.
• Prioritize whole, nutrient-dense foods: When following the keto diet, prioritize whole, nutrient-dense foods like eggs, fish, beef, pork, and lamb. These foods provide essential vitamins and minerals and can help support liver health.
• Consider supplements: Some supplements, such as BHB ketone supplements, may help reduce liver inflammation and injury. Always consult with a healthcare professional before taking any supplements.
• Monitor ketone levels: Measure your ketone levels regularly to confirm that your body has entered ketosis. This can be done using keto test strips.
• Be aware of potential side effects: The keto diet may cause temporary side effects like the "keto flu," which can include fatigue, headaches, digestive issues, and disrupted sleep. If these symptoms persist or become severe, consult your healthcare provider.
• Seek professional guidance: Consult a healthcare professional, such as a doctor or registered dietitian, before starting the keto diet, especially if you have any underlying health conditions or are taking medications. They can provide personalized guidance and help monitor your liver function throughout your keto journey.

Frequently asked questions