Re: BOHbutyrate blood level

[Guest guest]

Jill,

There's quite a few posts re bhb levels late Nov, early Dec. One of them

gives Freeman's guidelines, from memory, a serum level of 4 or above

indicated 'adequate' ketosis, but I think that refers to mmol/L. I took it

to mean a urine ketone correlation of between 8 and 16, but you will never

really get an exact comparison, as it depends on when the bladder filled

etc.

Was it a 'vein' test? We measure bhb levels with a home testing kit, but

with a fingerprick test, the blood is a capillary sample, containing plasma

etc, so approx 30% is added to our result to get a true serum reading.

's urine ketones are usually 16 by mid afternoon, the blood capillary

bhb level is always at least 3.2 or 3.3 by this time, if adding 30%, this

would mean a serum bhb of at least 4 mmol/L. I'm not sure how this relates

to umol/L though.

Hill

BOHbutyrate blood level

> Hi

> I eventually received 's BOHbutyrate blood test result that was done

> in December. It was 2200 umol/L. Could someone advise how this relates

to

> ketosis and what level we should be aiming for.Her urine ketones were 16 a

> couple of hours before the test was done. Would this be a fair

> correlation or would you expect BOHB to be higher ?

> Many thanks

> Jill

>

>

>

> " The Ketogenic Diet....a realistic treatment option, NOT just a last

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> List is for parent to parent support only.

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[Guest guest]

Jill,

Sorry can't help you out on that one coz i am in exactly the same

position as you, having just received Leahs BHB results but not being able

to contact her neuro for clarification!

Leahs results were as follows.....

B-Hydroxybut (20-100) umol/L 4270

Acetoacetate (15-50) umol/L 2580

Anyone any ideas........

Jeanette, mum to Leah, Australia

>

>Reply-To: ketogenic

>To: kuekids@...

>Subject: BOHbutyrate blood level

>Date: Thu, 10 Jan 2002 16:55:14 +0800

>

>Hi

>I eventually received 's BOHbutyrate blood test result that was done

>in December. It was 2200 umol/L. Could someone advise how this relates to

>ketosis and what level we should be aiming for.Her urine ketones were 16 a

>couple of hours before the test was done. Would this be a fair

>correlation or would you expect BOHB to be higher ?

>Many thanks

>Jill

>

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[Guest guest]

Hi Jeanette

No wonder we are confused - even the labs don't report results the same!

's test only had one result:

BOHbutyrate 2200 umol/L (25-295)

Her urinary ketones were consistently 16 at 8 seconds.

If we are comparing the same thing, Leah's result is significantly higher.

What readings were you getting for her urinary ketones?

I wonder whether the ketone sticks are not giving a true indication of

's degree of ketosis - that may explain the seizures she still

has. I may have to invest in a blood ketone testing kit if that is the case.

At 08:05 PM 1/10/02, you wrote:

>Jill,

> Sorry can't help you out on that one coz i am in exactly the same

>position as you, having just received Leahs BHB results but not being able

>to contact her neuro for clarification!

>

>Leahs results were as follows.....

>

> B-Hydroxybut (20-100) umol/L 4270

> Acetoacetate (15-50) umol/L 2580

>Anyone any ideas........

> Jeanette, mum to Leah, Australia

>

> >

> >Reply-To: ketogenic

> >To: kuekids@...

> >Subject: BOHbutyrate blood level

> >Date: Thu, 10 Jan 2002 16:55:14 +0800

> >

> >Hi

> >I eventually received 's BOHbutyrate blood test result that was done

> >in December. It was 2200 umol/L. Could someone advise how this relates to

> >ketosis and what level we should be aiming for.Her urine ketones were 16 a

> >couple of hours before the test was done. Would this be a fair

> >correlation or would you expect BOHB to be higher ?

> >Many thanks

> >Jill

> >

>

>

>

>

>_________________________________________________________

[Guest guest]

I am still waiting for 's results to come through.

In the " The Ketogenic Diet - A Complete Guide for the Dieter and

Practitioner " it states:-

" ...high levels of ketones in the bloodstream raise insulin slightly

and block the release of free fatty acids from fat cells. This seems

to imply that higher levels of ketones will slow fat mobilisation.

....ketosis is defined by the presence of ketones in the bloodstream.

Ketones in the urine simply indicate an overproduction of ketones

such that excess spill into the urine. It is conceivable for someone

to be in ketosis without showing urinary ketones.

....the rate of ketone body formation is determined solely by the rate

of incoming FFA. The production of ketone bodies in the liver

requires a depletion of liver glycogen and a subsequent fall in

malonyl-CoA concentrations allowing the enzyme carnitine palmityl

transferaseI (CPT-1) to become active. CPT-1 is responsible for

carrying the free fatty acids into the mitochondria to be burned. At

the same time the CPT-1 is becoming active, a drop in blood glucose

causes a decrease in the insulin/glucagon ratio allowing free fatty

acids to be mobilised from fat cells to provide the liver with

substrate for ketone body formation.

When carbohydrate intake is reduced - liver glycogen levels reduce

When liver glycogen levels are low - Malonyl-CoA levels reduce

When Malonyl-CoA levels reduce - CPT-1 becomes active

CPT-1 is responsible for transporting FFA to the Mitochondria to be

burned

When FFA are burned - acetyl-CoA is produced

When no CHO is available - acetyl-CoA cannot enter the Krebs cycle &

accumulates in the liver

High levels of acetyl-CoA - condense into acetoacetic acid

acetoacetate - can convert to beta-hydroxybuturate + acetone. "

With all the info available, even getting readings doesn't seem to be

an advantage anymore.

As everyone is different (some kids work best with trace to 4 ketones

where others are better at 16 all day) you need to find out which

level is best for your child and use info to help you maintain that

level.

Just to throw a spanner in the works...little more food for thought.

Australia