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Why Am I Not In Ketosis?

By Edited Oct 27, 2016 5 6

Are You Having Problems With Your Low Carb, High Protein Diet?

Smoked Pork Butt

Photo Credit: Vickie Ewell

You’ve decided to follow a low-carbohydrate diet. You’ve read Dr. Atkins New Diet Revolution or Dr. Eades' Protein Power Lifeplan and have stocked the house with low-carb foods. You’ve purchased a bottle of Ketostix because you’ve been told that they measure the state of Ketosis. You’re highly motivated to turn this luxurious way of eating into a lifestyle because you don’t have to count calories, and you believe you can eat all of the low-carb foods you want.

Your first week starts out great! You enjoy ham and eggs for breakfast and a jumbo bacon cheeseburger without the bun for lunch. For dinner, you grill a Porterhouse steak or enjoy a nicely smoked pork butt with a small dinner salad drenched in full-fat salad dressing. In between meals, you munch on sticks of cheddar cheese, deviled eggs, a few olives and a dill pickle. Although excited and anxious to see the urine test strips turn purple, when you test yourself, the color on the stick doesn’t move. In fact, it’s not even pink.

Okay. Maybe it’s just going to take your body a little bit longer than most to get into Ketosis, so you decide to wait a few more days and then test again. Those days come and go, but still no Ketosis. You believe you’re doing everything right. You haven’t eaten anything that wasn’t on the Atkins’ list of acceptable foods, so why are you not in Ketosis?

Why Am I Not In Ketosis Already?

One of the largest myths about the Atkins Diet is that you can eat all of the steak, chicken, bacon and eggs you want. Typical low-carb dieters shove vegetables aside and treat them as a condiment. Fruit is limited to a few berries. Many dieters don't even count the carbohydrates in sugar substitutes. If most of the foods you eat have little or no carbohydrates, you might believe the body cannot help but go into the state of Ketosis, but that is not true.

A low-carb diet is not always a ketogenic diet. While severely restricting carbohydrates is the quickest way to get into Ketosis, if you continue eating a high-protein diet beyond a couple of days, your biological makeup can prevent Ketosis.

The Atkins Diet Isn't Just Bacon and Eggs

Photo Credit: Vickie Ewell

Ketogenic diets limit the supply of available glucose. Since glucose is always burned before fats, lowering your carbohydrates coaxes your body into burning fats and ketones for fuel. If you eat mostly zero carb, high-protein foods, however, your liver might use that dietary protein to create all the glucose you need.

Basal insulin levels tend to drop quickly on a low-carb diet. If your insulin levels fall too low, the liver starts creating glucose from the available protein you’re eating. Since certain portions of the brain cannot burn fatty acids or ketones for fuel, gluconeogenesis is a backup starvation response that can work to a low-carb dieter’s advantage.

Gluconegenesis allows the liver to produce the glucose your brain needs to function properly. Technically, that makes carbohydrates not essential to sustain life. If you eat more protein than necessary, however, glucose will remain your major fuel source rather than fats. As long as glucose keeps its prominence, the body cannot go into the state of Ketosis. 

What Can I Do About Not Being in Ketosis?

Pick up your low-carb diet book and carefully look at the diet again. Neither Atkins nor Eades recommends a very low carb, high-protein diet unless you are extremely carbohydrate intolerant. The sample diet above contains less than 10 grams of carbohydrates and very few vegetables, yet many low-carb dieters eat that way every day. If your menu is similar, you are not doing the Atkins Diet or Protein Power correctly.

Although being in Ketosis is not required to make a low-carb diet work, overeating protein foods can keep your pancreas secreting insulin as it attempts to keep the level of ketones in the blood from soaring too high. When your insulin levels remain elevated, the body has difficulty mobilizing its fat stores. Your ketone level will also plummet.

If you’re following the Atkins Diet, the initial recommendation for the first two weeks is 20 net carbs per day, most of which must come from vegetables. Many low-carb dieters glide right on by the word “most.” Most doesn’t mean less than 10; it means more than 10.

In comparison, Dr. Eades recommends 30 net carbs and initially allows you more variety than Atkins does. Instead of slowly adding back carbohydrates, on the Protein Power Lifeplan, you simply eat anything you want, provided you stay within your carbohydrate tolerance. Dr. Eades also limits the amount of protein foods you eat per day depending on how much you currently weigh.

Although the 2002 version of the Atkins book allowed 3 cups of salad or 2 cups of salad and 1 cup of non-starchy vegetables, Dr. Atkins later amended that to a minimum of 12 to 15 net carbs from just vegetables. Low-carb diet plans are not meat, eggs and cheese diets, even though that’s how they are often portrayed in the media. In fact, Dr. Eades’ diet allows you to eat fruit, toast or low carb tortillas, and non-starchy vegetables from your very first day.

If you are not in Ketosis, the first step to correct the problem is to begin doing the diet correctly. 

What Does 20 Net Carbs Per Day Look Like?

To a new dieter, the lure of being able to eat bacon and eggs for breakfast, hamburgers for lunch, and steak for dinner is especially appealing. Go ahead and have them, but keep your portion sizes within the amount of protein you need to maintain your muscle and body tissues, plus a little extra for gluconeogenesis. That comes to about .8 grams of protein for each pound of lean body mass you have. Lean body mass is everything in your body that is not fat. Those who lift weights, participate in sports or have physically active jobs will need a little more, closer to 1 or 1.2 grams of protein per pound of lean body mass.

Once the body adapts to a ketogenic diet, many brain functions can use ketones for fuel. Although some functions will still need glucose, your protein needs still need to be about .8 grams per pound of lean body mass. Keto-adaption occurs in about two to six weeks, provided you haven’t eaten an excessive amount of protein or cheated with carbs during that time.

If Not in Ketosis You Might Be Eating Too Much Meat

Photo Credit: Vickie Ewell

Vegetables are an important part of a low carb diet. If you’re having trouble getting into ketosis, most of the time you are eating too much meat and cheese, but you can also be shorting yourself on vegetables.

Although vegetables provide carbohydrates that are turned into glucose, the brain cannot run completely on ketones. It needs a certain amount of glucose per day, and vegetables are a healthy, nutrient-dense way to get that glucose. They are also a great way to increase your fiber intake. On a low-carb diet, fiber isn’t counted because it doesn't raise blood glucose levels. When you subtract the grams of fiber from the grams of carbohydrates in the foods you eat, the result is “net” carbs.

There are many calorie and carbohydrate counters available online for free that can help you discover how many grams of carbohydrates and fiber are in the foods you’re eating. The following list of vegetables provides a little over 13 net carbs and a little more than 16 grams of fiber:

  • two cups of salad with celery, cucumber, radishes, and mushrooms
  • 1 cup cooked green beans
  • 2 cups of broccoli and cauliflower mix
  • 4 thick slices of tomato
  • half of an avocado

That still leaves you 7 net carbs to spend on salad dressing, eggs, cheese, cream, sugar substitutes and other incidentals such as low-sugar catsup or mayonnaise. You could also spend those extra carbs on more vegetables. 

The Problem of Metabolic Adaption

Low-carb diets are the most efficient method of shedding those excess pounds, but the key word here is "efficient." Because of that, the body can become so efficient in burning fat and calories that your muscles won't burn calories at the same rate it did when you first started your diet. The important thing to remember is that Ketosis is a metabolic state. It doesn't mean automatic weight loss. So it's always a good idea to minimize the effect of a low-carb diet as Dr. Mike Roussell explains in the following video.

Dr. Mike Roussell on Metabolic Adaption When Following a Low-Carb Diet

Ideas and Suggestions for Improving Metabolism When in Ketosis

Are High Protein Diets Always Good for Weight Loss?

Restricting carbohydrates lowers your basal insulin levels and thereby improves metabolic issues, such as insulin resistance, but isn’t isn't always better. If your insulin response is still strong enough to handle the effects of gluconeogenesis, you might be able to eat a low carb, higher protein diet and still go into Ketosis, but that won't hold true for everyone.

Since Ketosis is measured by the number of ketones built up in your bloodstream, not the amount of ketones spilling into your urine, it’s also possible to lose weight on a low-carb diet without being in Ketosis. For some individuals, the calorie deficit is enough. But if you’re struggling to lose weight, have stalled, or just want to experience the depressed hunger and increased energy that Ketosis brings, a low carb, high-protein diet might prevent Ketosis.

For those who are really struggling, there are new ways to check ketones in your blood through ketone blood meters and testing strips available at Amazon, Ebay, and other online sources. These meters and testing strips can help you dial in the macros of your diet to make sure you are eating the proper combination of protein, fats, and carbohydrates that will place you within the parameters of Ketosis.

Most people who have started to use these blood ketone devices have been very happy with the outcome. For those who thought they were eating ketogenic ratios, but weren't, protein and fats can be adjusted until the proper ketone level in the blood is reached. Overall, the greater majority of people who use these ketone meters have found that they need to lower their protein intake and up their dietary fats to get into ketosis as well as easily maintain that state. Results reports have been quite positive.



Aug 7, 2012 9:17pm
Hi: Your article is well written and informative--the best of both worlds--I admire the work you put into it and give you 5 stars for the piece--As for eating habits--I've never given much thought to carbs and so on but I eat very little meat, lots of veggies but just because I prefer them--still, your article was a great make-you-think narrative for me. Congradualions and keep up the good work.
Aug 8, 2012 3:52am
Thank you for your comments. I ran into this way of eating way back in the 70s when I discovered Dr. Atkins' first diet book in the library and got hooked. Like you, eating lots of vegetables works well for me too.
Sep 2, 2012 7:42am
LavenderRose, This could explain why I didn't go into ketosis on a diet last year... I went to a weight reduction doctor, took the pills, got the "shot", ate only protein for the first four days - no ketosis... Recently I won a 12 week program with another weight loss doctor and am on my 2nd day of protein only, out of 4 possible days... The stick is the same color as before I peed on it!!! Can I only reach ketosis by totally NOT easting???, because with this new pill, I could do that... I don't want to repeat the senario with the first dr again... I want this to work... Also, could a fatty liver be a culprit in not reaching ketosos??? Thanks Much, CAlexG
Sep 3, 2012 6:00pm
Ketostix (or whatever brand of testing sticks you're using) do not actually measure the state of Ketosis. They measure one of the two types of ketones that the body makes when carbohydrates are restricted.

Your brain, kidneys and heart do not use Acetoacetate ketones very efficiently, so the body initially dumps them into the urine. These are the type of ketones that many low-carb dieters look for. However, the body also makes Beta-hydroxybutyric ketones which "can" be used by the brain, kidneys and heart, so these ketones are not dumped.

The only way to know how many B-hydroxybutyric ketones you have in your blood (whether your in Ketosis or not) is a blood test. Ketone blood meters are now available, but they are so new that the strips cost something like $2.50 each! They are generally used by Type 1 diabetics.

As carbohydrate restriction continues, your muscles will convert Acetoacetate ketones into B-hydroxybutyric ketones, so the body can use them. That results in less ketones being dumped into your urine. If you are not new to a low-carb diet, you might not dump any at all! Even in the very beginning! Your muscles will already be proficient at converting the non-usable ketones into their usable form.

I never test positive on Ketostix, even on extremely low levels of carbohydrates, because I've been low carbing for years now.

By shot, do you mean the HCG diet? That diet is extremely low in protein. It's specifically designed to give you just enough protein so that you do not convert it into glucose. This article is directed towards a typical low-carb dieter that eats way more meat than they need!

Eating protein only won't automatically keep you from going into Ketosis. When I did the Kimkins diet several years ago, I ate only meat and eggs for the first week and still went into Ketosis. I ate 72 grams of protein or less, but I'm only 5-feet tall. You need about .6 to .8 grams of protein per pound of lean body mass.

Protein is only a problem if you eat more than your body needs for repairs and body maintenance. If your body uses the protein you eat for energy, rather than your fat stores, that's when it becomes a problem. You don't want to eat extra protein because then it will convert into glucose. I discovered this to be true when I attempted a zero carb diet, but on that diet I didn't keep my protein limited. I ate all I wanted. and my blood glucose level went through the roof.

So the first question to ask yourself, is how much protein are you eating?

Are you losing weight? The first week on a low-carb diet, you should drop a lot of weight because you're using up your glycogen stores. There is something like 3 or 4 grams of water attached to every gram of glycogen, so are you going to the bathroom more than usual?
Large drops in weight do not always happen with seasoned dieters however. The body sometimes stuffs water into your empty body fat cells as a place holder, waiting for carbs it thinks you're going to feed it later on. Plus, large drops also depend on how many carbs you're eating before you begin to diet. Since I'm pre-diabetic, I don't generally eat more than 100 carbs per day, even on maintenance.

How is your hunger level? If you are not in Ketosis, your hunger will increase.

Also check your measurements as the diet progresses. If you are not in Ketosis, you won't lose any inches.

Your hunger level and loss of inches (do your clothes fit better?) are much better indicators of being in Ketosis than urine test strips.
Aug 11, 2015 4:25am
Well explained - all the details about ketosis except the nausea? When pregnant I suffered from ketosis and felt terrible! it was difficult to then eat something to alleviate the queasiness. I alte whatever my imagination could tempt me with. Even Marmite on crackers (carbohydrates?) Yet I suffered from"burning myself up".
I am interested, because in South Africa they are crazy about the Banting diet - similar to the ones you mention. But you make a good point about ketosis. Well done
Aug 14, 2015 4:08pm
Thanks. I've only experienced the nausea when I tried eating zero carb for a few weeks, and my body didn't want to eat any more meat. However, I was super nauseated when pregnant the first time and wasn't eating much. I didn't even think about some of that being from ketosis.
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  1. Robert C. Atkins, M.D. Dr. Atkins' New Diet Revolution. New York: M Evans and Company, Inc., 2002.
  2. Michael R. Eades, M.D. and Mary Dan Eades, M.D. The Protein Power Lifeplan: A New Comprehensive Blueprint for Optimal Health. New York: Warner Books, 2000.
  3. Michael R. Eades, M.D. and Mary Dan Eades, M.D. The 30-Day Low-Carb Diet Solution. Hoboken: John Wiley & Sons, Inc., 2003.
  4. Robert C. Atkins, M.D. Atkins for Life: The Complete Controlled Carb Program For Permanent Weight Loss and Good Health. New York: St. Martin's Griffin, 2004.

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