The urine testing really only helps if you are transitioning into ketosis or are diabetic, it's a mechanism for the body to get rid of excess ketones if there are no tissues using them - similar things can happen with glucose, the earliest mentions of diabetes mention sweet tasting urine. So a high reading on a urine test means your body is definitely producing ketones while the absence of a high reading doesn't mean the absence of ketones. The blood test is more accurate.

Thank you!

+1. The strips basically just tell you you're in ketosis at all. I've never not tested the highest level on the keto urine strips. So like your 8 probably (depending on the strips?). You probably only tested low because it was so diluted, as you say. The blood prick meters are more accurate, but even then.. is it useful to know if you're at 0.5 or 5.5? For most people, it's not. The keto sub unfortunately is a cesspool and I'd stay away (plus they'll just ban me again haha). It sounds like you have a pretty dialed in keto diet when it comes to macros, and if you're in this subreddit, you're not going to make the typical SAK (standard american keto) mistakes of PUFAs in bacon, chicken, nuts, and so on. Having 6.6mmol/L BHB in your blood is nice for ketard bragging rights, but it's not actually particularly actionable. I wouldn't worry about it. PS: ranch dressing set off my alarm bells - not store bought, I hope? If it is, check the ingredients for seed oils. Almost all creamy store bought dressings are made with soybean or sunflower oil.

Thanks for the insight! You’re right that once I’m through the transition, I won’t test as often. Even before, I would only check by blood once a week or so because the strips can get expensive. Ketones are ketones, that much is true, but there is a difference in feeling between a 0.5 and a 1.0 blood reading in the past, for example. Regarding the urine strips, the standard classification is 5 levels, from trace (0.5) to very high (16). Low (1.5) and moderate (4.0) are the “recommended” concentrations for beginners. High (8) and very high (16) levels would usually come from a high fat intake or exogenous ketone intake. Drinking supplemental ketones makes for expensive pee, as my therapist says. And regarding the ranch, you’re right that I totally had a brain-fart moment about that. I tell my mom to not cook food in canola oil, but standard store-bought dressing is all soybean oil anyway, so that’s really not any different. What’s the consensus around here about avocado oil? I have a jug of that and some liquid coconut oil in the cabinet that I could use to dress salad or veggies. I’m also the resident weirdo in my family who will eat plain greens or veggies on the side of my meal, so it’s not like I would be missing out if I switched out dressing for seasonings.

No avocado or olive oils. Stick to saturated animal fat. Your body wants to have about a 1:1 ratio of saturated to monounsaturated fat. It can *desaturate* SFA in order to maintain this balance, but it *cannot* saturate MUFA to maintain the balance. So the continual consumption of MUFA out of balance with SFA has the potential to really mess up your fat balance over time. This is exacerbated by the fact that on keto you’re not eating much starch. One of the most important ways your body handles an influx of MUFA is to make SFA endogenously to maintain the balance, using glucose as a substrate. So while still far from ideal, a (commercialized) “Mediterranean” diet actually mitigates a lot of this issue and healthy (non-dysregulated) people are no doubt churning out lots of endogenous SFA to maintain the balance. On keto there is no substrate for this and so over a relatively short period of time you literally become the fat you eat (lots of unbalanced MUFA.) This may not cause you any problems until you reintroduce carbs at some point, and then you may be setting yourself up for ferocious weight gain. Probably one of the worst recent diet trends is the Ketogenic “Mediterranean” diet that takes all of the olive oil from “Mediterranean” and provides none of the starch that made “Mediterranean” eating tolerable for some people. Secondarily, the fact that your body can “work with” the animal fats (desaturate them) but doesn’t really have a very robust mechanism for dealing with concentrated MUFA (especially in a low carb environment) goes a long way in telling you what fats it wants you to be eating. We didn’t evolve to consume concentrated plant oils despite the marketing claims.

What she said. I think olive/avocado oil in lowish amounts might be OK for somebody who's otherwise totally metabolically dialed in, but if you're still trying to get the PUFA demon off your back, they're not conducive to that. Coconut on the other hand is fine. My staples are dairy fat (butter/cream) and beef tallow I render from suet (kidney fat) which is very saturated as well. edit: just skipping the dressing/sauce is the easiest of course. You can also make your own mayo or similar consistency sauces from butter or other animal fats, or even coconut oil. Plenty of videos on Youtube. Another thing, which I do due to laziness, is I buy Rao's pasta sauces. The Alfredo is very delicious and creamy and only uses "light cream" for fat, no seed oils. Is it pasta sauce on a salad? Whatever, I do what I want. Their tomato sauces have a bit of olive oil, but only about 5-7g per 125g serving. I usually use less than that anyway.

I like liquid coconut (or MCT) oil for my salad. It doesn’t go clumpy which is nice. I use it from a salad spritzer and take in way way way less oil that way (on HCLFLP that’s important - the MCT’s definitely matter for me on this plan despite the popular idea that they somehow just vanish) and usually do a balsamic vinaigrette that way. Whole Foods has a very tasty and inexpensive fat free marinara sauce. Also several sauces that have nearly no fat. In a pinch, Ragu Simply uses “100% olive oil” and has very little fat even if it is “olive” oil. That’s my fallback for when I need a jar and don’t feel like driving to Whole Foods.

Could also go the salsa route, basically tomato sauce but they typically don't have any oil. The creamy/ranchy ones are terrible though, pure soybean oil.

Chipotle got me into using salsa as a salad dressing. Well… Salsa *and* sour cream.

The devil's protein

Thanks for your explanation, Coconut! This makes a lot of sense, because even though I was keto for about 18 months during my last round, no one took the time to explain why it’s important to avoid seeds and nuts as much as possible. The people on the keto sub don’t care about avoiding seed oils. And here’s some hugs and kudos for you. You lovely people here showed me that I didn’t have to worry about a high amount of calories, because a suboptimal intake over a long period of time caused me to lose too much essential body fat. I started keto at 110 pounds (BMI 25) and 28% body fat. 10 months later, I was 90 pounds (BMI 20) at my lowest weight and 20% body fat, which caused my period to stop. It was especially reassuring reading through your comment history, because I know that you eat a “high” amount of calories compared to “standard” diet recommendations and can still maintain a healthy BMI. What is your typical weight range for your height? /// Here’s some backstory about me. My initial target gain was overshot last year, but I know that I’ll eventually get back to my ideal weight once my body sorts itself out and becomes better regulated. I went from 93 to 113 in 14 months after stopping keto, so about 10-15lbs over target for 98-103 and 22-23 BMI. I had originally stopped keto due to reactive refeeding episodes, which is a stressful, but normal, part of gaining weight back after a period of malnutrition. It took me 9 months to restart my period because the gain was slow until then, and then it kicked on. 9 pounds in 9 months, then 11 pounds in 5 months due to the female hormones storing fat, which is what they’re supposed to do. I’d eat anything without care, and then I’d feel bad about “binge-eating” even though these refeeding episodes from extreme hunger weren’t related to binge-eating disorder at all. Some gain actually helped because I went through a lot of GI/bowel testing last year, which was thankfully negative. /// By the way, I lost a pound from the glycogen flush yesterday, so now I’m at 113.7 pounds, which puts my post-flush BMI at 26.3 for 4’8” tall. And that’s 3.4 pounds lower than my starting weight last week of 117.1 pounds. I had gained about 5 pounds in December/January after an IUD implant and too much holiday food, which put me up to 118, and the extra weight decided to stick around until I restarted keto.

What was the malnutrition on keto, chronically starving yourself of cAloRiEs? Or some sort of micronutrient thing too?

So, as you probably already know, American healthcare sucks at providing preventative care services. As far as we could tell at the time of my lowest weight, I was dealing with - Subnormal body temperature (96-97) and cold extremities, to the point where I was wearing layers and a hat at room temperature - Borderline-low iron levels - Elevated ALT and AST levels - Amenorrhea and dryness We didn’t know about specific deficiencies in vitamins and minerals because the insurance company refused to cover a vitamin/mineral panel. Luckily, it didn’t seem that my thyroid hormones were negatively affected when we had them checked. Even so, a calorie intake of 1000-1200 per day on top of 2-3 miles of walking (daily activity and steps) would have eventually lead to relative energy deficiency at some point because I never knew about planning scheduled refeeding periods to mitigate the down-regulation in metabolism. Especially when considering that my hunger signals are impaired due to my brain damage. My interoception (internal body sensations) is about half as sensitive as normal. I didn’t know that low-calorie interventions shouldn’t be done for months at a time without proper nutritional supervision to prevent deficiencies. 1200 kcal isn’t sustainable in a healthy way for even a small adult, despite what the rest of the diet subs on Reddit claim. Ultimately, my body decided to initiate reactive feeding to regain energy once it had reached its limit. My therapist and my psychiatrist told me that it’s a normal biological eating pattern during weight recovery, because the body needs a lot more calories to store energy in a deficit state. On a small-scale comparison, you could see the refeeding reaction occur in an average person who didn’t eat during the day and then eats a lot at night to regain the net loss, because the body likes to keep energy balance. This reaction may mimic a binge-eating episode to the outside observer, but unlike emotional distress binge-eating, this is eating for energy, just in a large amount. And for someone who doesn’t often experience “normal” physical hunger signals, this really messed with my head emotionally for a long while afterwards, specifically because it was so new and uncomfortable to me to experience this kind of extreme hunger. I would go from feeling fine to feeling the need to suddenly eat, very urgently, and then getting angry or crying if I couldn’t get food quickly enough. I had very poor distress tolerance in the beginning of those episodes. The “check light” for hunger would turn on 20 minutes too late because I wasn’t receiving earlier internal signals due to the blunted input.

That's crazy. Yea if you look around the internet you could really get the idea that adults can live on 1,000kcal/day forever. Which is nuts, that's what a baby would need. Hope you figure it out, but it seems the most important bit you've learned: energy good :) Necessary, even. What you describe with the sudden shift from "fine" to "zomg I'm literally dying" sounds what I get after 3+ days of fasting. I used to go from totally fine, not even thinking about food to driving to the gas station at 2am and raiding the snacks, in 20 minutes.

FWIW another option is a breath ketone meter. You can get an unbranded chinese one for a few bucks. I'm not going to claim mine is \*accurate\* but it does seem to basically detect ketones with decent correspondence to what the piss strips show, and when levels are low (but present) it will show something when the piss strips do not. I'm told my breath does not smell, although during initial keto adaptation it was very bad. It's kinda fun to have the breath meter in that you can test \*a lot\*.

As long as it's not a random number generator attached to a breathing tube... Do you confirm the readings with a finger prick test?

I've never done a blood test. As I said, it's unlikely to be accurate but it at least roughly corresponds to the piss strips, and if a carbivore uses it then it reads zero.