Glucose Ketone Index (GKI) – What Ratio Do I need for Nutritional Ketosis Benefits?

Generally these blog posts are a result of scratching my own itch (answering my own question), and this post is no different.

At the time of writing this, I’m doing a 5-day fast, and wanted to understand the readings I’m getting for my blood glucose and blood ketone levels.

Initially I thought that blood ketones were all that mattered, and certainly a lot of people only talk about that reading. But looking at Dr Thomas Seyfried’s paper on treating brain cancer (glioblastomas).  It suggests that its important to take into account blood glucose also. In their study, they acheieved optimal results when their patients maintained what they called ‘nutritional ketosis’. And as part of the paper, they included a formula for what this means.

The chart below describes visually what they mean by nutritional ketosis, and how it affected the tumour growth. The red is an increase in ketones as a fictional patient goes deeper into ketosis. The black line represents blood glucose, that decreases to a plateau, as carbohydrate sources are removed from the diet, and glycogen stores decrease.

So that sweet spot they reach at the end is an optimum level of nutritional ketosis. Now… obviously in our case we are (hopefully) not trying to slow the growth of a glioblastoma. But by getting into ketosis we’re hoping to achieve a number of benefits including:

  • Reduced IGF-1
  • Immune system rejuvenation (perhaps mainly lymphocytes)
  • Increased cellular autophagy
  • Reduced inflammation (often measured by improved C-reactive protein levels)

The extent of these benefits will depend if you’re eating a keto diet, or doing a water fast/fast mimicking diet. But all 3 should improve the biomarkers such that you have a reduced risk of major diseases such as diabetes, cancer and cardiovascular disease.

And studies like this one indicate that the optimal benefits from ketosis lie in maintaining  a 1:1 or lower ratio of glucose to ketones.

So on to the crux of this post, how to calculate GKI. What you’re trying to do is compare apples with apples, you really really want both readings in mmol/L. In my case, having a meter sourced from the UK, that’s how they came, so I simply do:

Glucose Reading (mmol/L) ÷ Ketone Reading (mmol/L)

However, if you’re in the USA, your blood glucose reading will be in mg/dL. You’ll know, because the meter should say mg/dL. But to be sure, if you blood glucose is in the 100s as a score, rather than single digits, that’s likely mg/dL.

So you’ll want to convert that glucose reading into mmol/L by doing:

Your Glucose Reading (mg/dL) ÷ 18.02

This converts your reading from mg/dL into mmol/L, and then you can do the above calculation (glucose reading divided by ketone reading) to get your glucose ketone index score.

So that’s it really, pretty simple.

Links that may be of use:

1 – Thomas Seyfried et al’s paper on using the glucose ketone index to treat brain cancer:
The glucose ketone index calculator: a simple tool to monitor therapeutic efficacy for metabolic management of brain cancer

2 – An excel calculator for the GKI, developed by Dr Seyfried’s colleague Joshua Meidenbauer:
Glucose Ketone Index Calculator

What sticks out for me with all this stuff, is how amazingly valuable it can be in our treatment (and prevention of cancer), and yet in 2017 an incredibly small number of people (& physicians!) know and understand this work. For those with cancer, if its combined with other treatments (described by Dom D’Agostino here), its even better. Its 5 years since Thomas Seyfried published his book ‘Cancer as a Metabolic Disease’. Time will tell how fast we are able to communicate this “meme” to a wider audience.

Rhonda Patrick on the Nootropic effects of sulforaphane

This excerpt is taken from Rhonda’s recent podcast with Tim Ferriss.

Summary of the main benefits she mentions, in the context of nootropics:

  • Positive effect on mood and alleviated depressive symptoms and reduced anxiety (so far confirmed in mouse models, with a current trial underway to test in humans)
  • Improved short term and spatial memory (so far proven in mice, in the context of conditions that affect memory such as alzheimers)
  • Increase in neurite outgrowth – which is how damaged neurons and synapses repair themeselves from injury

And here’s the full excerpt:

“Getting past all of the usual suspects on our list of nootropics here, the other nootropic that I actually take frequently is SULFORAPHANE! It’s not even usually considered a nootropic by most people but I think it has potential to be considered at least a mild nootropic for a variety of reasons. One of the the best reasons to make this argument is the fact that sulforaphane crosses the blood-brain barrier, at least in mice. This is the first criteria that a substance must meet in order for there to be a compelling argument that it somehow exerts effects on the brain — but, in addition to that, it also affects the activities of the immune system which is now known to affect the brain through a series of lymphatic vessels. this new understanding of the immune system’s ability to interact with the brain also helps to explain why manipulating levels of systemic inflammation has, in clinical trials, been shown to affect feelings of depression either inducing depression in the presence of an artificial increase in activity in the immune system by injecting things like interferons into human trial participants or reducing depression caused by this artificial increase in inflammation through the co-administration of a natural anti-inflammatory, such as eicosapentaenoic acid, better known as the omega-3 fatty acid EPA.

In addition to sulforaphane crossing the blood-brain barrier in mice, the compound has been shown in a couple of randomized, double-blinded, placebo-controlled studies in humans to have one sort of effect or another on brain and behavior. For example, treatment with sulforaphane extracted from broccoli sprouts at doses ranging from about 9 mg to about 25 mg, which is an amount that might be found in around 65 grams of fresh broccoli sprouts on the high end, was able to improve autistic behavior checklist scores by 34% and significantly improved social interaction, abnormal behavior, and verbal communication in young men with autism spectrum disorder. Similarly, some measurable effects have been shown in a small trial of people with schizophrenia.

The fact that sulforaphane is exhibiting clear effects on the brain and behavior of people, such as those with autism spectrum disorder, hints that it might continue to show promise in other areas of cognition too. This is because animal studies have really shown a diversity of very interesting effects that are really just waiting to be replicated in humans.

For example: Sulforaphane has been shown to improve spatial working memory and short term memory in mice in the context of conditions that can affect memory in a deleterious way, such as Alzheimer’s Disease. It has been shown to increase neurite outgrowth, which is how damaged neurons and synapses repair themselves after damage from traumatic brain injury. The effect of sulforaphane on a rodent model of Alzheimer’s Disease in some respects is particularly interesting, because, if we go back to our conversation a little bit earlier about the potential choline may have for mitigating some of the negative effects of this disorder, sulforaphane has also been shown to significantly reduce memory impairment that has been experimentally induced by a drug that works specifically by interfering with the effects of acetylcholine in the nervous system, a drug known as scopolamine.

Sulforaphane was, in this animal trial to which I am referring, able to improve the cholinergic system by increasing acetylcholine levels, decreasing acetylcholine esterase activity, and increasing choline acetyltransferase, which is the enzyme responsible for synthesizing acetylcholine in the hippocampus and frontal cortex. This ties in nicely with some of our discussion earlier about the potential importance of the choline system in cognition. Finally, sulforaphane has been shown to have a positive effect on mood and alleviated depressive symptoms and anxiety as effectively as the antidepressant Prozac in a mouse model of depression and I understand that there is at least one trial currently in the beginning stages looking to confirm this effect in humans as well.

If you consider the variety of brain and behavioral effects demonstrated already in humans, I’m optimistically hoping that some of the groups out there working on these questions will have something good to show for it in the future.”

See the full Tim Ferriss podcast for more info.

And see this post on sulforaphane supplements + info on how to grow broccoli sprouts yourself, which contain the glucoraphanin and myrocinase your body needs to convert into sulforaphane.

Thriva Review – How Does It Work? What Does It Tell You? Is It Worth The Money?

Ever since I heard about a San Francisco based startup called WellnessFX, I’ve been interested in getting blood tests.

The way Tim Ferriss described periodic blood testing with WellnessFX, it sounded so obviously important, that I couldn’t understand why we don’t do it.

He described it like this. Imagine trying to tell what’s happening in a football game, if all you’ve got is one freeze frame on the tv. Now imagine you’ve got freeze frames every few minutes, you can start to build up a picture of what’s happening.

That’s not too dissimilar to blood testing, if we can build up a picture of our hormone and vitamin levels over time we can pre-empt illness, and take evasive procedures to avoid it.

And then… I came back to Earth, and remembered I’m in the UK, without private healthcare. And the only way I’ll get blood tests on the NHS is if I have symptoms. I need to be ill otherwise they don’t want to know.

So I kinda forgot about the blood tests for a while, until a friend mentioned Thriva.

They offer a basic panel of blood tests (Cholesterol, Triglycerides, Vitamin D, Iron & Liver Function) for £49.

And the great part about their test, is you don’t need to go anywhere to do it. They send you a small pack in the mail that gives you everything you need to take your own blood (less than 1ml!) and send it back to them.

How Does It Work?

Here’s what the kit looks like, and how to use it (roughly speaking):

It’s a game changer really. All of a sudden it allows people to take health into their own hands.

What Does It Tell You?

So you’re probably wondering… okay, so I send my blood off… what next? Here’s a quick video showing the Thriva dashboard where you can get your results:

Is It Worth The Money?

If you’ve got a health care plan that covers tests like these, then sure, there’s no need. But for the rest of us, £50 is a reasonable price to pay for keeping on top of our health. 

How could they improve things?


Currently the number of tests available through Thriva is limited. However, they are working on expanding things.

My ideal scenario, would be for them offer a large range of blood tests, all at affordable prices, and available through the mail. I believe there are some tests that should be taken in a clinic setting (e.g. homocysteine), but if they can get the majority to work via mail that would be ideal.

Currently they offer recurring tests, so that you can measure progress over time. Again, more customisation on those tests would be good.

Additional tests I’d be interested in seeing include:

  • Glycated Hemoglobin (A1C) – which measures 3 month average plasma glucose concentration. High levels = bad
  • C Reactive Protein (CRP) – this is a substance produced by the liver when inflammation is present. High levels = bad
  • Dehydroepiandrosterone (DHEA) – is a precursor to testosterone and estrogen, produced in the adrenal glands. Low levels = bad

But credit where credit is due. Thriva is a relatively new company, which may or may not be profitable yet. They need scale. What they’ve done so far is incredible, and I hope they’re able to continue to do so.


What Causes High Blood Pressure & Why It’s BAD

If you’ve elderly family or friends with high blood pressure (or who MIGHT have high blood pressure), DO check whether or not they’re keeping it under control. The consequences if they don’t are BAD, and not worth the risk

Didn’t realize the importance of this for a long time, and after a recent family incident, I’ve had to get up to speed on what’s going on.

Rest of this post explains my understanding of the science behind managing high blood pressure…

Pretty much from the day we’re born, to the day we die, our arteries accumulate crud (plaque). As this crud builds, it forms layers, and gradually this narrows the arteries. This happens to EVERYONE, no matter how good your lifestyle is. But certain factors like diet, stress and exercise affect how much plaque builds up.

Narrowing of your arteries increases the pressure of the blood being pumped. Think of it like a hose, as you put your finger over the end of the hose, the pressure of the water coming through increases (good for spraying things!). That same thing is happening inside your body. The heart still needs to pump blood around, and the narrowed arteries cause it to move at greater pressure.

A “healthy” blood pressure is around 120 / 80 (doesn’t need to be exactly that)

The first number (120) refers to the amount of pressure being exerted as the heart pumps. The second number (80) refers to the pressure right after the pump, as the heart fills up, ready to pump again.

150 / 90 and greater is considered “high blood pressure”.

Your body can function normally with high blood pressure. Which is why its easy to ignore. The problems mainly occur when you’ve had high blood pressure for a long time. It can weaken the structure in the blood vessel walls, potentially leading to the wall breaking.

This can happen anywhere in the body. But the place with some of the smaller (weakest?) blood vessels is the brain, and certainly its the place with the greatest consequences. If it pops in the brain, that’s a hemorrhagic stroke… not good.

Sometimes people think they can control blood pressure through diet & exercise. And whilst its true that some foods can help lower blood pressure, its takes a lot of work. So if there’s any risk that diet ISN’T getting the full results, consider medicinal drugs. Don’t let fear of “drugs” from protecting your body.

So yeah, old people, watch out for them. Take their high blood pressure seriously, even if they don’t. And who knows, maybe you’ll keep them in good shape for longer than they would otherwise.

What if you got cancer today? Here’s how Tim Ferriss’ podcast guest, Dom D’Agostino, responded

Recently Tim Ferriss got together with Dom D’Agostino to discuss cancer prevention. Dom is currently doing cutting edge research into the affect of things like fasting, ketosis and metformin on cancer cells.

During the interview, Tim poses a fascinating question…

“What if you found yourself with an aggressive form of cancer, what steps would you take?”

[Read more…]