Will This Kick Me Out Of Ketosis?

A common question people have when starting keto is “will this kick me out of ketosis?” I’m going to address as many items as I can think of and explain why it will or will not kick you out of keto. This is going to be as comprehensive as possible so either use ctrl + f to find what you’re looking for or buckle up and read on.

 

How do humans enter ketosis in the first place?

Things will become much more clear if we explain how humans enter ketosis. Mainly, liver glycogen is what determines if ketones will be produced. Specifically, glycogen in the liver signals malonyl-coa to be formed by carboxylating acetyl-coa. Acetyl-coa  is used in many processes and it’s the main substrate used to be turned into ketones.

The wiki on regulation of ketogenesis which applies to this scenario says “When the body has no free carbohydrates available, fat must be broken down into acetyl-CoA in order to get energy. Acetyl-CoA is not being recycled through the citric acid cycle because the citric acid cycle intermediates (mainly oxaloacetate) have been depleted to feed the gluconeogenesis pathway, and the resulting accumulation of acetyl-CoA activates ketogenesis.”

Basically, when there is more acetyl-CoA than oxaloacetate, the acetyl-CoA becomes acetoacetate, a ketone body. In plain English, carbs provide oxaloacetate, so if it doesn’t have carbs, it likely isn’t going to kick you out of ketosis. I’ll state the exceptions later.

 

Why do humans enter ketosis so readily?

Humans enter ketosis faster than any animal on the planet. It usually takes 24-36 hours before we enter ketosis.This is because we have huge brains and tiny bodies. Our brains need ~400 calories/day, which for most people that equates to 20% of our total energy demands. To put this in perspective, most animals only use 2-8% of their basal metabolism for their brain. This means our small liver glycogen stores of 100g are the only way of the brain getting glucose. There are no other glucose storage components that the brain can take from. This means at 400 calories/day, those 100g of glucose get used up in 24 hours. Doing the math, that means our brain consumes ~4g glucose/hour.

Therefore, even if something does kick you out of ketosis and we assume that all the glucose provided goes to the brain (it doesn’t), then just assume a 4g/hr clearance. Ate 20g extra carbohydrate? Don’t freak out, you’ll be back in ketosis within 5 hours max.

 

Where is the brain getting its energy?

Expanding on the above concept, if the brain doesn’t have glucose, the body will make ketones to feed it. The brain needs to get energy from somewhere, if not glucose, then where? Lactate can be used, but you need to be metabolizing carbs to get lactate, so that isn’t practical. Ketones are the only other solution. I ask this question often when people think something kicks them out of ketosis: “if not glucose or ketones, where is the brain getting its energy?” That question is the basic litmus test for ketosis. If the brain is short on energy by even just 50 calories, that will be made up by producing ketones. No energy for the brain = death. No exceptions. To find out if a biochemical scenario would kick you out of keto, ask “are they alive, then where is the brain getting energy?” Usually it’s glucose or ketones.

 

Does an insulin spike kick you out of ketosis?

Short answer: a little bit, but not really enough to freak out over because insulin clearance is fast.

Long answer:  Here is a study where a dude fasted for almost a month. His ketones were high (14 mmol/l) and he was injected with insulin (around 0.1 IU/kg, so around 7-8 IU). For 30 min, his ketones and blood sugar dropped, there was a massive uptake of ketones by the brain and ketone production was halted. However, because insulin clearance is fast, within 30 min his ketones started shooting back up. It didn’t take him long even with insulin because no oxaloacetate was provided.

 

Fructose doesn’t spike my blood sugar, does that mean I won’t be kicked out of ketosis?

Fructose is the most anti-ketogenic sugar available. It cannot be metabolized anywhere but the liver because nothing else has the enzymes to metabolize it, therefore it refills liver glycogen rapidly. It is guaranteed to take you out of ketosis, alongside being harmful to the liver. Avoid it like the plague.

This means avoiding fruits also. It is better to consume 10g of fructose free carbohydrate (potato, rice, dextrose only candy like Smarties) than it is to consume 10g of fruit. On average, 50% of the carbs in fruit are fructose. Glucose can go to muscles instead of the liver, meaning liver glycogen stays empty. Fructose must be metabolized in the liver, meaning bye bye ketones.

 

What about gluconeogenesis (GNG)?

Okay this one is trickier. GNG happens all the time on keto. They are synonymous. In the scope of this article, we won’t address how “excess protein” impacts keto because that’s an article on its own. But lets talk GNG specifically.

GNG and ketogenesis can happen together. Just because GNG is initiated doesn’t mean ketosis stops. They occur together all the time. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2129159/ This study says “The hormonal changes associated with a low carbohydrate diet include a reduction in the circulating levels of insulin along with increased levels of glucagon. This activates phosphoenolpyruvate carboxykinase, fructose 1,6-biphosphatase, and glucose 6-phosphatase and also inhibits pyruvate kinase, 6-phosphofructo-1-kinase, and glucokinase. These changes indeed favor gluconeogenesis. However, the body limits glucose utilization to reduce the need for gluconeogenesis.”

The body doesn’t use as much glucose when glucose isn’t available (what a smart body), so therefore it doesn’t need GNG as much. In fact, there is little difference in the amount of glucose created via GNG on keto vs the amount created on a high carb diet.

 

That is enough evidence to show that ketosis and GNG happen together, but what of the glucose created via GNG?

Well, it doesn’t matter if the glucose provided via GNG becomes metabolized and produces oxaloacetate because GNG clears oxaloacetate. In essence, this means that regardless of glucose produced or metabolized via GNG, the oxaloacetate provided is likely to be retaken up as necessary to be used for GNG instead of beta oxidation of acetyl-CoA, meaning that acetyl-CoA can become a ketone. Yay!

 

Even if I consume all my protein at one meal vs 6?

Yes, regardless of the huge spike in insulin, as I stated above insulin itself will not destroy ketosis unless oxaloacetate is provided. Protein also spikes glucagon the same amount that it spikes insulin. Glucagon increases ketogenesis.  No issues here.

 

When does fat become anti-ketogenic?

Fat is primarily ketogenic (90%) but also has a slight anti-ketogenic effect (10%). This represents the fact that ten percent of the total fat grams ingested will appear in the bloodstream as glucose (via conversion of the glycerol portion of triglycerides). If 180 grams of fat are oxidized (burned) per day, this will provide 18 grams of glucose from the conversion of glycerol.

 

What about artificial sweeteners?

Some artifical sweeteners do turn into glucose when metabolized. Look at this table and find your sweetener on it that you are about to consume. GI doesn’t always work as a direct comparison to glucose, since fructose doesn’t raise blood sugar but it does take you out of ketosis. So use this table, if the sweetener has a GI above 5, count it gram for gram as equivalent to any other carb. This means you can still consume it if you will stay under your carb limit for the day. For those sweeteners with a GI less than 5, count every 3g of the sweetener as 1g carbohydrate.

 

Alcohol?

Alcohol (ethanol) is metabolized into acetyl-CoA.  It doesn’t provide glucose or oxaloacetate. If you don’t consume carbs with your alcohol, the alcohol actually increases ketosis because the acetyl-CoA:oxaloacetate ratio gets even higher. The body tries to clear the acetyl-CoA by producing more ketones.

The downside is that by providing more acetyl-CoA, alcohol stops your body from using its own fat stores to create more acetyl-CoA, therefore slowing down fat loss. Calories count.

 

Nuts, dairy, any other whole food?

Look at the carb count. How many carbs does it provide, and is that going to put you over your carb limit for the day? There is nothing magical in these foods that will take you out of ketosis.

Caffeine will not take you out of ketosis nor does it spike insulin.

 

What about the filler in pills?

Some pills use pure table sugar for filler, others use talc or another benign powder. Even if it happens to be pure sugar, weigh your pill. It’s likely only .5g, therefore it’s no more than .5g of sugar. Add it to your carb count if you’re that pedantic.

 

MSG – Monosodium glutamate

MSG is one sodium molecule (monosodium) bound to a glutamate molecule. Glutamate is a non-essential glucogenic amino acid. It can be converted to glucose, but nobody consumes enough MSG for this effect to be significant. Most of the time you’ll consume milligrams worth of MSG. Obviously many grams of carbohydrate will be necessary to kick you out entirely.

This article will be updated as other relevant questions arise.

About Author

Dustin Sikstrom
Low carb since 2010, ketogenic since June 2013, lifting consistently since September 2013. Musician and music teacher, sax, guitar, and drums. You can't brute force biology, but you can outsmart it and work with it.

44 Comments

  1. Mich

    Great information-thank you! A lot of information to absorb!!! I think I saw you recommend whey protein-is whey protein the best to take in ketosis? I was introduced to a plant protein and have been mixing it with coconut milk, spinach/kale and a small amount of berries (the carb count is higher than I would like for a meal but, I am still keeping my total carb count where recommended). Should I be doing anything different?!

    Reply
  2. Jay F

    Because everyone is talking about drinking boullion cubes to help with salt retention and help with cravings, I have been drinking warm water with liquid Aminos – from bragg. The sodium levels are pretty high but I am worried about the amino acids promoting GNG and subsequently kick me out of ketosis. I would estimate to take about 25 ml in one serving about three or four times…
    Independently, I am getting cravings for salads and would eat 12 to 16 cups of spinach and lettuce salad over two meals during the day. While the total net carbs for the day stays below 50 gr, I sometimes feel tired in the afternoon and question the impact of those salads. Any comments?
    Thank you.

    Reply
  3. Sandeep sasane

    Hii, i m in ketosis from last 25 days but accidentally i had some more carbs in my 25th day. So does it kick me out from ketosis?? If yes, then how much time it will take to come back in same.
    Pls reply

    Reply
  4. Joe

    If you have an insulin spike after being in ketosis, how long would it take to bounce
    Back into ketosis?

    Reply
    1. Rick Passmore

      “Insulin spike” needs clarification, as most things people think are “spiking it” are negligible and transient. Unless you’re eating carbs, it’s unlikey anything will actually kick you out of keto.

      Reply
  5. Keith-Brandon

    This was by far one the most informative ketosis articles I’ve read. It answered a lot of the deeper metabolic questions I’ve had for a while. It thankfully gave some insight as a lifter that the temporary effects of excess protein are short-lived in ketosis. Thanks.

    Reply
  6. Samantha

    Hi there, great article about ketosis. I recently started the Cambridge Weight Plan diet which is supposed to work by pushing your body into ketosis but something I’ve done or eaten must have knocked me out because I am soooo hungry right now.
    I’m a bit doubtful whether the CWP products are really, truly ketogenic because they seem to be quite high in carbs. The shake I had this morning had 25g of carbs, and the bar I had at lunchtime had 24g of carbs. Other sites say that you have to stay under 25g of carbs to stay in ketosis, so I’d really like some advice on this. Cambridge doesn’t advocate eating fats but other Ketogenic diet plans insist on fats.
    What effect does exercise have on ketosis? Could I have knocked myself out of ketosis by training too hard yesterday?

    Reply
    1. Rick Passmore

      Keto advocates higher fat only because you need to displace the lost calories from carbs, and as protein should be based on lean mass, you only have fat to play with for calories. You’ll need to keep below 30g net each day if you want to ensure you’re in ketosis. depending on how many carbs you’re having each day with their foods, you’re likely in and out of ketosis which can make you hungry and often miserable.

      Training will not knock you out of ketosis but hunger is still expected if you’re eating at a deficit.

      Reply
  7. Jessica

    I’m confused by it all. I’ve been trying to get into ketosis for almost a month now. My BG was reading 98 prior to IF but is now 78 in a fasted state. I’m unsure about my macros though. I’m getting less than 5 gram of carbs a day, but I think my proteins and fat may wrong. Current weight is 344lbs down from 375. Also I am 5’5″ and 41 years old. Please help, the keto calculator says I am supposed to 1673 calories a day. As I stated I’ve coupled intermitten fasting 16:8 with a keto diet.

    Reply
    1. Luis Fernando Martinez Funes

      if you’re doing less than 30g net of carbs you are in ketosis. BG has nothing to do with it. Control your macros and follow ketogains calculator recommendations.

      Reply
    2. Samantha

      The easiest way to get your macros right is to use the app My Fitness Pal, coupled with the info from the keto calculator. If you eat too much protein, it’ll keep you out of ketosis. I am eating 5% carbs and im in ketosis.
      But youve lost 30 lb! That’s fantastic. Juat keep going. Your calories seem ok, for about a 30% deficit. Is that what you wanted? I’m 41 as well and have a lot to lose (about 80 lb).

      Reply
  8. Julia

    Hey – thanks for a great post. Anything about milk/lactose?

    Reply
    1. Rick Passmore

      It’s a sugar so yes. Lactose isn’t special unfortunately.

      Reply
      1. Krista

        If I eat beans will I be knocked out of ketosis ?

        Reply
        1. Luis Fernando Martinez Funes

          check their macros, that will answer your question

          Reply
  9. Jerry R. Morris III

    I am just starting a Keto Diet and do heavy weight lifting every other day. I was curious as to if L-Glutamine will take me out of Ketosis because I am getting really conflicted reports when trying to search it. Some say don’t worry about it. Some say it raises Glycogen, which if I am reading this article correctly, is fine, and some others say to avoid it completely as it will surely take you out of Ketosis. I am conflicted on who is just biased and who is actually trying to help others with these diets. My protein powder that I take has 5,000 mg in it and I also have a tasteless powder that has another 5,000 mg in it(No other additives). Would it be detrimental to Ketosis to take both, or does it not really affect it? I also take BCAA’s, Fish oil, a multivitamin, and biotin. I can’t find a comprehensive list of supplements or vitamins that affect Ketosis so I’m having trouble figuring out what I should and shouldn’t avoid. Any help would be appreciated!

    Reply
    1. Jerry R. Morris III

      By the way, I forgot to add that I am ensuring I take in less than 20g of carbs a day as well.

      Reply
      1. Rick Passmore

        L-Glutamine has the potential to be turned into glucose, that does not mean that it will nor does that mean that it would kick you out of ketosis.

        Reply
  10. Michal

    Maybe you already mentioned this but what if you consume whey isolate one scoop with fats? can this kick you out of ketosis?

    Reply
    1. Tyler Cartwright

      No

      Reply
  11. Keets

    I am in keto for 2 weeks and still no
    Weight loss. How do I know if my body is burning my body fat or just the dietary fat?

    Reply
    1. Rick Passmore

      Keto does not cause weight loss and two weeks is a bit too short to call it a stall, if over the long term you’re not not losing fat mass, you’ll know you’re simply eating too much of it and burning dietary fat.

      Reply
  12. Amber

    So if I ate 5 strawberries, will that throw me out of ketosis?

    Reply
    1. Luis Fernando Martinez Funes

      if those 5 straweberries make you go above your carb daily intake, yes probably.

      Reply
  13. Brandon

    I’m sorry if this has been covered already, but I am lifting and cardio 5-6 days a week some days double days. If I sip on amino acid and take creatine is it going to constantly kick me out of ketosis? Or will I be ok doing that? Is there times to drink it that are better than others? I am new to this and trying to learn as much as possible

    Reply
    1. Rick Passmore

      No they won’t kick you out of ketosis, also, toss the BCAAs in favour of whey protein.

      Reply
  14. mtaylor7210

    How did you balance a low carb diet with weight training.
    I just started Ideal protein and they have you shy away from exercise during the weight loss phase.
    But I would also like to start lifting again so I’m trying to find a happy balance.

    Reply
    1. Luis Fernando Martinez Funes

      In Ketogains we don’t shy away from weight training at any time. You must develop your muscles continuously. The first weeks of Keto you will feel week while adjusting and your lifting will suffer but as you become more adapted your strength will come back.

      Reply
  15. Luis

    Dear Dustin,
    Great post!
    I havetype 1 diabetes and by practicing a LCHF diet I find much easier to control my blood sugar levels hene less peaks and better stability. I like to practice sports fitness and “extreme” endurance and after the chirstmas peridod (no keto or low carb at all) I am trying to get back in shape. I am 1 week on a LCHF diet but my estimation is that I intake between 40-60g of carbs per day. I did not mesure yet if I am in ketosys (blood sample) because today was the planed day, but after 30min of fitness yesterday night I woke up in hypoglychemia. So after all that, my question is:
    1. Would basal insuline which causes hypoglychemia (muscles empty of glucogen) kick me out of ketosis?
    2. Would that reset the counter to get keto-adapted?

    Thanks a lot in advance!

    Reply
    1. Dustin Sikstrom (Post author)

      Tough question. There really isn’t a whole lot of info for T1s. The approach needs to be different for sure, but in what way, I don’t know. I’ll have a crack at it with what I do know.

      1. Exercise activates glucose metabolism even in the absence of (extra) insulin. What did your blood glucose drop to? You may try either reducing insulin post workout or moving your carbs to post workout. Gng should keep up with refilling glycogen, but if insulin is too high (or insulin sensitivity went too high from exercise which I believe this to be the case) then gng would be limited.

      2. No this won’t keep you from ketoadapting. The only thing that would do so is to not have enough ketones present. Between 40-60g carbs might be too much. Other T1Ds I’ve talked with suggest more carbs than average, but really more like 30-50. And I think gradually reducing the carbs while reducing insulin would be the safest approach to avoid these wild glucose swings.

      Reply
      1. Luis

        Thanks!
        I like the research (on mysefl) of this diet and as I said it makes glucose control easier. However I face problems to follow it. Here in Europe (pasta, potatoes, bread… based) meals are quite common and when having people over I have the tendency to offer them with carbs, and then I consume them as well. That keeps me out of ketosis at lease “once” a week. Then when I go back to the diet my liver starts glucogenesis for 1.5 days and makes the control harder, becasue I do not count on that glucose present in my blood to correct it with insulin. Then even though I might eat lo carb (lots veggies, virgin olive oil, nuts, avocado…) I am disappointed when I see my blood sugar high. That goes on from Monday till Tuesday night and the extra insulin taken to compensate for the liver glucogenesis will probably kick me out of chances of ketosis. That makes a best case scenario of 3 to 4 days of ketosis (0.6mmol/L) which is not even a “good” ketosis. keeping me out of the keto adaptation. I have noticed that even fiber counts into my insulin intake and that is why I count up to 60g of carbs (gross).

        I wonder if this diet might not be “healthy” when not able to achieve adaptation.

        When I get low in sugar I might get down to 2mmol/L (36 mg/dL) which is dangerosly low but it is not necesarly related with the keto diet it is just the unpredictability of chaning of insulin sensitivity. Solvable by trial and error approach.

        Anyway, thanks again for your answer. I’ll try to take a even more sistematic approach and exercise more regularly and not just random days random trainings/effort during the week. I will keep fighting for a good health, great glucose control and good condition. Maybe I ever see my abs, who knows :).

        Cheers!

        Reply
  16. @KetoRich

    Nice job Dustin, while coaching people into and in Ketosis this is a common question I get all the time. Thanks for providing a great answer!

    KetoRich

    Reply
  17. Handyortung

    Hell I don t even mind how nearly masochistic it all is until it gets to one of two points, either someone tries telling me what I do is unhealthy citing their fallacious pseudoscience, or when I see someone genuinely struggling to make a change in their life and not knowing who is right before siding with the masses because there wasn t enough accessible transparent easy-to-grasp science to choose between. What makes you think you ve been kicked out of ketosis?

    Reply
  18. Amy

    Wow…I’m planning a post on how irritated I get when I hear or read the phrase, “I got kicked out of ketosis.” People really do not seem to have a good grasp of the biochem involved. Looks like you beat me to it, here. This is *great* stuff. People just get completely demoralized when they see that pink/purple on their urine test strips go away, and it’s ridiculous. I want to tell them no big deal! Carry on with your solid LCHF diet and check again in a few hours. No need to do “penance” with an hour on the treadmill, or a 24-hour fast. Honestly, this is the mindset out there sometimes. Oy!

    Reply
  19. Dale Hicks

    Okay, so your comments about how insulin spikes are short term and don’t effect ketosis, but what about the numerous folks who are insulin resistant and even type 2 diabetics? Where does all that insulin go that has created the metabolic syndrome and insulin resistance to start with?

    Reply
    1. Dustin Sikstrom (Post author)

      High insulin is an effect of metabolic syndrome/insulin resistance. Not exactly the other way around. Which begs the question, how does insulin resistance form then? Nobody has a definitive answer that I’ve been able to find yet.

      The fact remains, insulin clears out of your system quite rapidly. When injected with insulin alone, no calories/carbs/oxaloacetate, CJ (from the study) was back to producing ketones within 30 min. It really is oxaloacetate that keeps you out of ketosis for a significant amount of time.

      Reply
  20. Mike

    Does gluconeogenesis replenish muscle glycogen, or is that glucose reserved solely for the brain? Does being in a ketogenic state – and training in one – make us a more “aerobic machine” because we are robbing our body of the anaerobic glycolysis energy pathway?

    Thanks for such a thorough and well-explained article.

    Reply
    1. Dustin Sikstrom (Post author)

      It appears that post exercise, in a fasted state with water only, glycogen is restored. The only way this could happen is via GNG.

      //www.ncbi.nlm.nih.gov/m/pubmed/8455450/

      In that study, people exercised in a fasted state, one group given water, another group given carbs. Both groups replenished their glycogen.

      > As anticipated during the initial 2-h recovery, the CHO trial had a significantly greater rate of muscle glycogen resynthesis as compared with the H2O trial. The muscle glycogen content was restored to 91% and 75% of preexercise levels when water and CHO were provided after 6 h, respectively.

      So adding carbs got their glycogen back sooner, but staying fasted they actually replenished MORE muscle glycogen (though I don’t see a P value so I don’t know if that’s statistically significant).

      Then your second question. We MIGHT be slightly more of an aerobic machine. That’s a much bigger question. In terms of limitation of anaerobic capacity, there aren’t enough studies done on keto adapted individuals.

      From an anecdotal perspective, it took me 6 months of keto for me to feel like I had my anaerobic capacity back. But I also had keto flu during my 3rd week of keto. Perhaps my body adapts slowly? I have no explanation. Regardless, I still lift heavy 5 days a week with significant volume and <50g carbs daily. I'm not arguing that anecdotal evidence counts either. Just saying that I don't think the literature applies to my experience that I've had myself and with the many members on Reddit and Facebook Ketogains.

      Reply
      1. Tommy

        I think this is a great post – easy to understand and informative!

        About the study you mention here regarding glycogen repletion, though, the abstract is highly misleading. Glycogen was only depleted to 71% of pre-exercise value by the exhaustive exercise protocol (sets of 6 reps of leg extensions at 70% 1RM with 30s rest until failure), so after 6h only 4% of glycogen had been recovered. The difference in glycogen repletion in the two groups was statistically significant (p<0.05). In fact, the last sentence of the discussion says: "Without caloric consumption, the muscle glycogen content was barely elevated (75%) above the level of depletion (71%). This isn't a comment in the greater scheme of things, just on what that particular study showed.

        I think, in general, muscle glycogen levels seem to be maintained around 70% of maximum during periods of ketosis. However, liver glycogen depletes much more rapidly in the face of fasting or carb restriction than muscle glycogen does, and this is also very relevant to the maintenance of ketosis, as you point out.

        Reply
        1. Dustin Sikstrom (Post author)

          Did the abstract get the numbers backwards? The way I see it read is: water-91%, CHO-75%. I thought it was odd that water only recovered more glycogen.

          Wish I had full access. 🙁

          Reply
          1. Tommy

            Yeah, the abstract is backwards. If you’ve got an email address I’ll gladly send it over!

  21. Kathleen

    I use liquid stevia to sweeten my drinks, salad dressing, coffee, protein shakes, etc. I’ve heard that anything that tastes sweet will cause your body to automatically release insulin, whether or not there are any calories being consumed. Do you know if this is true? I’m wondering if this is the cause of my weight loss stall. Stevia has been such a life saver for me on low-carb…I have such a sweet tooth!

    Reply
    1. Dustin Sikstrom (Post author)

      There are arguments both ways as to whether or not stevia will spike insulin. It seems to depend on the person. Even if it does, it’s a non-caloric sweetener, and like I said above, insulin spikes are quite short term and have negligible effect on ketosis and weight loss, as long as calories are not involved.

      How closely are you tracking? What are your macros? Exercise? Sleep? How long have you been stalled?

      Reply
    2. Dustin Sikstrom (Post author)

      Some people get and insulin response, others don’t. Like I stated in the article, insulin responses without carbs have negligible effects on ketosis. Even if it does kick you out of keto, it’s not for long (30-60 min max).

      Reply

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