Reasons You May Not Be Producing Adequate Ketones [Part 3]

7. A medication or combination of medications is taxing your liver.


Medications can “manage” chronic illnesses like diabetes and obesity, but they cannot prevent or reverse them. But following a ketogenic diet is a potent way to prevent or reverse these common chronic diseases. As a clinician, I like having safe approaches that work with my patients. If you start by focusing on your diet, then the rest will be merely window dressing.

– Dr. Bill Wilson


Both prescription and over-the-counter medications can be hard on your body. Yes, sometimes drugs are necessary, but they can add more toxins that your liver needs to flush out of your body. This is very important, since most medications, including common over-the-counter ones, can be damaging if taken long-term. They may help manage symptoms in the short-term, but that comes with a price if it becomes a maintenance drug you take for the rest of your life.

What does this have to do with ketosis? Well, the liver is involved in regulating insulin levels, and when it’s under strain from dealing with medications, your insulin can remain elevated. (This doesn’t mean you should necessarily stop taking your medications. If you’re concerned, please consult with your physician about the risks and side effects of the specific medication you are taking.) When insulin levels are high, this can knock down your body’s ability to create ketones.

If you are able to come off of your prescription medication or forgo taking an over-the-counter drug, you may see your ketones begin to rise. It’s certainly something you should be aware of if you are struggling to see results in your ketone testing.

DOCTOR’S NOTE FROM DR. ERIC WESTMAN: In diet and metabolism studies conducted in the early twentieth century, carbohydrates were called “the anti-ketogenic factor.” Eating carbohydrates raises insulin levels, and it’s the increase in insulin that turns off the production of ketones.

8. You’re consuming too few or too many calories.


Following a well-formulated ketogenic diet with adequate calories to support your needs is unlikely to cause problems over the long term.

– Franziska Spritzler


We haven’t discussed calories very much in this book, and for good reason. When you are eating a diet that is low in carbohydrates and moderate in protein, and you’re consuming real, whole sources of dietary fats to satiety, calories take care of themselves, without any need for you to become obsessed with counting them. But in the pursuit of ketosis, some people can run into trouble with consuming calories either well below or beyond satiety.

In chapter 12, we discussed ways to distinguish true hunger from other factors that prompt you to eat, because with the abundance of food in our society, we’re used to consuming a lot of food and eating for reasons other than hunger—making it difficult for us to know when to stop eating. And on the flip side, our society glorifies hunger as a good thing in the realm of dieting, which puts pressure on us to eat fewer calories than our bodies probably need. Both of these extremes can play a major role in your ability to produce therapeutic levels of ketones.

Encourage the production of ketones by paying attention to your hunger, eating enough food that you don’t feel the need to eat again in two hours, and being careful not to eat until you are so stuffed that it hurts. This doesn’t mean you obsess about calories; that would also be counterproductive. Just as you have to find your carb tolerance and protein threshold, experiment to find the amount of calories that makes you feel satisfied and lets you produce ketones at a beneficial level. You can do this!

Mindful eating is never a bad thing, and making sure you don’t lowball yourself or overdo it on the calories could help the ketones start pouring through your veins very quickly.

9. You’re eating food too often throughout the day.


We are living in an age when eating is not just about sustenance, it’s also about fellowship and enjoying life. That’s part of the reason there is a stigma attached to anyone who chooses not to eat with everyone else in a social gathering. There’s immense peer pressure at work, your church or synagogue, or even at home to put food in your mouth simply because it’s that time of day. But could eating too often hinder your ability to make ketones? You bet it could.

In chapter 11 we discussed the role of intermittent fasting in ketosis, and the two work in tandem—consume a low-carb, moderate-protein, high-fat diet with enough calories to completely satisfy your nutritional needs, and you should be able to very easily go twelve to twenty-four hours between meals without any problems at all. The proper composition of the core components of that meal (carbohydrate, protein, and fat) along with the extended period of spontaneous fasting will do so much to help your body get into ketosis. There’s no need to partake in another meal if you are still satisfied by your previous one.

When someone asks you why you’re not eating, you can respond, “I am eating . . . ketones!” The look on their face when you say this to them will be priceless.

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