Christa - BHB levels

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Hi Christa - Here is an article pasted below from Hopkins regarding

optimum bhb levels.

I emailed one of the authors a couple of yrs ago to check whether the

levels they quoted are vein or capillary (home test kits measure capillary

blood which is 'watered down' with plasma etc) and they said they are using

vein figures here - their test kits were apparently calibrated to allow for

the difference.

So if your results are lab ones, they would probably be vein readings, on

a home test kit, you would add about 20% to the result to get a vein

equivalent.

We find that does best with ketones in the 3.5 - 4.5 (vein) range,

but this varies, some need lower, some need higher.

Those of you who check the BHB levels - do you know

about what range we are shooting for? Danny's doc is

consistantly ordering the levels with other labwork,

but we aren't sure what we are looking for. We've

kind of figured out Danny's by drawing them on

seizure-y days and when he is in acidosis and other

times too, but is there a standard?

Christa

mom to Drew (2 and very typical) and Danny (5 with

COX-2 deficiency and secondary carnitine deficiency

and seizure disorder, etc. - keto since July 2004)

The ketogenic diet: seizure control correlates better with serum

beta-hydroxybutyrate than with urine ketones.

Gilbert DL, Pyzik PL, Freeman JM.

Pediatric Epilepsy Center, Department of Neurology, s Hopkins Medical

Institutions, Baltimore, MD, USA.

The objective of this study was to determine the relationship between

beta-hydroxybutyrate levels and seizure control in children on the ketogenic

diet. Seventy-four children on the ketogenic diet presenting for routine

follow-up visits had blood levels of beta-hydroxybutyrate correlated with

their seizure control. Forty-two children admitted for initiation of the

ketogenic diet had urine ketones measured by dipstick and correlated with

simultaneous blood levels of beta-hydroxybutyrate. Blood

beta-hydroxybutyrate levels statistically correlated with seizure control (P

= .003). Children with blood beta-hydroxybutyrate levels greater than 4

mmol/L were significantly more likely to have a decrease in seizure

frequency than those with levels less than 4 mmol/L. Urine ketones of 4+

(160 mmol/L) were found on dipstick when blood beta-hydroxybutyrate levels

exceeded 2 mmol/L. Seizure control correlates with blood

beta-hydroxybutyrate levels and is more likely when blood

beta-hydroxybutyrate levels are greater than 4 mmo/L. The traditional

measurement of urine ketones by dipsticks in children on the ketogenic diet

provides a less than optimal assessment of the degree of blood ketosis.

Three to four plus (80-160 mmol/L) urine ketones are necessary, but not

necessarily sufficient, to achieve optimal seizure control in children on

the ketogenic diet. At present, however, urine ketones are the only readily

available inexpensive approach to ketone assessment.

Publication Types: a.. Evaluation studies

PMID: 11198492 [PubMed - indexed for MEDLINE]