Inward Bound – Facebook Live with Dave Korsunsky and Sopurkha Kaur

Inward Bound – Facebook Live with Dave Korsunsky and Sopurkha Kaur

In this Inward Bound episode, Dave Korsunsky speaks with Sopurkha Kaur, owner of Awareness Generation, to promote habits for better sleep. From the orientation of your bed to breathing exercises for optimal relaxation, view the video and see actionable tools that are sure to improve your sleep with a few adjustments.

Sopurkha Kaur is a Level Two Certified Kundalini Yoga Teacher who, for the past nine years, has observed astounding personal transformations in students after consistently incorporating simple yogic based promoting habits. Kundalini Yoga is designed for the modern busy person who has a desire to heal and evolve through mind-body practices but also needs to focus on jobs and families. David discusses how we can employ these promoting habits in our daily life and quantify them with the latest digital health technology.

What you’ll learn in this episode on sleep:

  • How the position of your bed affects your sleep based on its relation to the earth’s gravitational pull on your body.
  • How Left Nostril Breathing affects energy flow and produces calming for sleep(guided Left Nostril Breathing is practiced at the end of the show)
  • How the firmness of your bed affects your sleep. Make sure your spine is supported by a firm bed.
  • The importance of strenuous exercise every day. Getting at least 30 min sets the body up for great sleep.
  • Be mindful of when you stop eating before you go to bed, as digestion can delay deep sleep.
  • Hydration is key in allowing the brain to rest and rejuvenate.
  • Lower lights, switch to candles before bed, unplug and avoid blue light devices for a couple of hours before bed.
  • There are approximately 72,000 nerves that end in the feet, soaking your feet in icy cold water for 3-4 minutes before bed will instantly calm your entire nervous system and your organs throughout your body.
  • Using acupressure/foot massage on your feet before sleep to support your organs can be really helpful too.
  • Track your heart rate, HRV and sleep with a tracking device so you can start doing your own n=1 experiments to find out what is most affecting your sleep.
  • Inward Bound – SLEEP Breathing Exercises.  The mind follows the breath. When we consciously control our breath, the mind has no choice but to listen to the cues the breath is giving it.   To practice Three Part Breathing, place your left hand on lower belly, right hand on chest. Close your eyes and inhale and exhale only through the nose. Start the inhale at the left hand/lower belly—the belly should expand. the second part is the rib cage starts to expand and the third part is that the clavicle lifts. Then on exhale do this process in reverse, clavicle, rib cage, and finally belly.
  • Left Nostril Breathing example. The left side is attached to the moon energy, cleansing, calming, cooling energy. This is best before bed to gear down for sleep. Make sure you’re keeping your mouth closed, breathing only through your left nostril, and make the in and out breaths equal amounts of time.

Join us every Friday on Facebook Live for a new episode of Inward Bound, where Dave Korsunsky interviews experts in the areas of mindfulness, meditation, and other body awareness techniques and how you can track them through Heads Up Health to learn more about how to support your unique health and body.

About Heads Up Health

Heads Up Health is an app designed to empower individuals who want to take a self-directed approach to managing their health. Instantly centralize your medical records, connect your favorite devices and apps (e.g., Oura, MyFitnessPal, Keto-Mojo, FitBit, Apple Health, MyMacros+, Withings and many more) and use data to optimize your health.

About Awareness Generation

Awareness Generation elevates workplace productivity, engagement, teamwork, and health by teaching people how to transform stress into vitality. Enjoy unconventional training taught on or offsite through varying length workshops—customized to the business goals. Programs are people-centric, fuses perfectly into any industry, offered across the globe, and focused on Igniting Human Brilliance in the Workplace.

Five Steps to Jump Start the Keto Diet

Five Steps to Jump Start the Keto Diet

In this post we will take a look at how Heads Up Health can help you successfully navigate the challenges of implementing and maintaining a ketogenic diet. In particular, we will introduce tools that can help you track your progress, fine tune your approach and find exactly what works for your own body as you adopt a low-carb ketogenic lifestyle.

Ketogenic Ratio Tracking

Ketogenic Ratio Tracking

While a ketogenic diet may have gained a lot of popularity recently, it’s origin dates back to 1923, when Dr. Russell Wilder started using it at the Mayo Clinic for the treatment of pediatric epilepsy. At the time, pharmaceuticals were not available to treat epilepsy, and it quickly became the go-to treatment due to its efficacy.

Though we now have drugs to support the suppression of seizures in those with epilepsy, not all medications work for everyone, and some individuals have found they have even better control when they eat a ketogenic diet. And not to be exclusive, one therapy can exist with the other, meaning you can combine a ketogenic diet with the therapies you’re already on and may even find that over time you’ll be able to reduce those medications, though you should always communicate with your provider of significant dietary changes so they can monitor your medications. *never go off medication without your doctor’s support and guidance.  Sudden withdrawal of anti-seizure medications can cause seizures.

What is the ketogenic ratio?  

Simply put, the ketogenic ratio is the ratio of fats to carbs + protein in grams measurements in the diet. While most ketogenic diet followers won’t go quite this far with their tracking, it can be critically important for those following a ketogenic diet for therapeutic reasons, like epilepsy.

As you can imagine, calculating this out for every meal can be very time consuming if done manually, which is why automating these calculations whenever possible can decrease the frustration that parents or individuals sometimes feel when using a ketogenic diet for therapeutic reasons.

What is The Classic Ketogenic Diet?

A classic ketogenic diet requires a high level of fat with a very low level of combined carbs and proteins, usually 4:1 or 3:1 (fats to carbs+protein)

For example, on a 2000 calorie diet with a 4:1 ratio, you would have 200g of fat, and a combined total of 50g carbs + protein.

As you can see below, the carbs and the protein are further broken down based on the individual’s protein need to roughly 6% protein and 4% carbohydrates.  Your doctor or nutritionist may modify this depending on your body weight, activity level, and seizure control.

Keto_RatioNote* This is an example only. Your calculations will be custom to you and your dietary needs.

Which ratio is better?

That really depends on your goals. While a 4:1 ratio may be how the diet originated, most adults use more of a 3:1 ratio due to their increased need for protein based on weight, but this all depends on your level of seizure control and should be determined by your doctor. You can read more about the different ratios on the Charlie Foundation’s website here.

Isn’t a ketogenic diet hard?

When the ketogenic diet comes up in regards to a child’s therapeutic diet, it is often met with resistance because it seems difficult or hard to comply with.  However with the recent interest in the ketogenic diet for many applications-from diabetes, to cancer, to weight training, it has become much more common, with food bloggers making it a common household word.  Add in all of the apps available for calculating macronutrients, and pair it with your Heads Up Health profile removing all the calculating and it becomes much easier!

How can I do a ketogenic diet without calculating everything?!

Though macronutrient ratios need to be more specific and consistent with a therapeutic ketogenic diet, it no longer has to be complicated to track.  Heads Up Health has integrated another new feature to let you track your ketogenic ratio when linked to your food tracking app like Cronometer, My Fitness Pal, MyMacros+ or FitBit nutrition trackers.

Just enter all of your foods eaten into your food tracker, which will link with your Heads Up Health account, and the calculations for your ketogenic ratio are done for you, letting you know at a glance if you’re on track or not.  With the new mobile app (coming soon), you’ll have this info easily at your fingertips at all times.

How to set up your Heads Up Health profile for ketogenic ratio tracking

To get your ketogenic ratio widget, click on the “+” button at the bottom of your widgets, click on “data source,” and select keto ratio from the drop-down menu. From there you will enter your goal.  If you are aiming for a 3:1 ratio, enter 3 in this field.


Once you have your widget, you can drag it to the top of the screen, so it’s easily viewed.  Next, click on your username in the top righthand corner of the page, click on Settings and select either total or net carbs under the ketogenic ratio section.


Total Carbs include the total amount of carbohydrates in your food.

Net Carbs is total carbs minus fiber in that food.  

If you select total carbs, you’ll be complying more strictly; however, you will be allowed much fewer carbs than if you choose net carbs and account for the fiber that slows the carbohydrate’s glucose response in your body.

Make sure your food tracker like Cronometer, My Fitness Pal, MyMacros+ or FitBit nutrition tracker is linked to your Heads Up Health account.

To connect your food tracker to Heads Up Health

Click on “Connect Data” in the upper right corner of the page near your name.


Once you’ve gotten your food tracker connected and your keto ratio widget on your dashboard, rearrange them in a way that makes sense for you at a glance.  Here is an example of how yours could look.



For more detailed information on the therapeutic use of the ketogenic ratio and how it’s used in epilepsy treatment visit the Charlie Foundation.


Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here.

Low-carb Lab Testing — Part 8: The Coronary Artery Calcium Test – A Better Way to Evaluate Cardiovascular Health

Low-carb Lab Testing — Part 8: The Coronary Artery Calcium Test – A Better Way to Evaluate Cardiovascular Health

What is the CAC test and why should you care?

If you’ve been following a low-carb or ketogenic diet for a while, there’s a chance your cholesterol has gone up.  And not just your HDL, but also your LDL—the so-called “bad cholesterol” (even though that’s a total misnomer).  Maybe your cholesterol has actually gone sky-high, and your doctor not only wants you to start taking medication immediately, but she’s also ordered you to quit your “crazy” high fat diet.  Even if you follow some other kind of diet—Paleo, vegetarian, low fat, or no special plan at all—maybe your cholesterol is high, and you’ve been told you need medication, or that you should exercise more.

Your doctor is only looking out for your best interest, but if they’re not up on the latest research, they might not know that your cholesterol level tells you very little about your risk for cardiovascular disease or a heart attack:

There’s “a growing volume of knowledge that challenges the validity of the cholesterol hypothesis and the utility of cholesterol as a surrogate end point.” (DuBroff, 2017)

It’s possible to have low cholesterol but massive heart disease, or to have very high cholesterol but be in great cardiovascular shape.

If you don’t want to start a war with your doctor, but you also don’t want to abandon a way of eating that’s helped you lose weight, have more energy, and maybe even reduce or eliminate diabetes medications, you can experiment with lowering your cholesterol by using the Feldman Protocol, which we featured here at Heads Up Health.  But there’s a much better way to evaluate your cardiovascular health than just looking at cholesterol.  It’s called the coronary artery calcium test (CAC).  We’ll explore it in detail in a bit.  First, let’s look a little closer at the problems with using cholesterol as an indicator of heart health.

Cholesterol is Protective

Evidence continues to build that cholesterol levels—including LDL—are not accurate indicators of cardiovascular disease risk, and that the medical community as a whole may have gotten “the cholesterol story” very wrong.  For starters, there’s the inconvenient truth that many people who have heart disease or experience a heart attack have “normal” or even low cholesterol.  Low cholesterol is no guarantee against a heart attack, nor is high cholesterol a one-way ticket to heart disease and sudden death.

In fact, evidence suggests that higher cholesterol—again, including LDL—may actually be beneficial, especially in your golden years.  A growing body of research indicates that high LDL cholesterol (LDL-C) is inversely associated with mortality in most people over sixty years of age.  Inversely associated means, the higher the LDL, the lower the risk for mortality.  To be fair, everyone’s risk for mortality is 100%, at least so far as we know.  So when we say there’s a lower risk for mortality, it means that someone has a smaller chance of dying from anything other than a nice old age.  This finding—that high LDL seems protective in some ways—has given researchers “reason to question the validity of the cholesterol hypothesis.”

This is especially true for older people.  Epidemiological and observational studies show that, for most people over 60 years of age, high LDL-C is inversely associated with mortality.  Researchers have also noted a “reverse epidemiology” among the elderly wherein slightly higher blood pressure, BMI, and cholesterol seem to be protective for health.

High Cholesterol Is Not a Disease

Cholesterol is a surrogate indicator.  It’s a measurement, not an illness.  Neither high total cholesterol nor high LDL-C, in particular, is a disease, in and of itself.  They have long been considered markers for cardiovascular disease or risk of heart attack, but this ignores the crucial fact that neither the number of LDL particles in your blood nor the amount of cholesterol carried in them indicates anything about the degree of atherosclerotic plaque built up in your major arteries.

Measuring the amount of cholesterol in your blood provides no information whatsoever about the accumulation of calcified plaques in coronary arteries—that is, how “clogged” your arteries are—or are not.  With this in mind, the obsessive focus on lowering cholesterol by any means necessary may have actually worsenedthe very epidemic of heart disease these treatments were intended to stop.  The authors of one paper made a powerful case that “the epidemic of heart failure and atherosclerosis that plagues the modern world may paradoxically be aggravated by the pervasive use of statin drugs,” and proposed “that current statin treatment guidelines be critically reevaluated.”

Bottom line: statin drugs do lower cholesterol, but having lower cholesterol doesn’t guarantee protection against heart attack or heart disease.  Plus, statins don’t just lower cholesterol.  The biochemical mechanism by which they do so comes along with a host of other effects, some of which have drastic implications for cardiovascular health.  To name just two, statins interfere with healthy mitochondrial function and also impair the synthesis of crucial vitamin K2.  Vitamin K2 is a “traffic cop” for calcium: it helps deposit it where it belongs, like in your bones and teeth, and helps steer it away from places you don’t want it, like your artery walls, your joints, and your kidneys.  So you can see how a deficiency in this critical vitamin could lead to arterial calcification, and it has nothing to do with the amount of cholesterol in your blood.  (You can learn more about this fascinating but underappreciated vitamin in the book, Vitamin K2 and the Calcium Paradox.)

Enter the CAC Test

Since people who have heart disease or suffer heart attacks run the gamut from low cholesterol to high cholesterol and everything in between, using total cholesterol or even LDL as the determinant of whether someone’s at risk for a cardiovascular event is as misguided as gauging metabolic health and carbohydrate tolerance solely through measurements of blood glucose, while ignoring the crucial role of insulin.

With all this in mind, more physicians are taking advantage of the coronary artery calcium scan.  Unlike serum cholesterol measurements, which, again, are only surrogates, the CAC provides direct observation of arterial calcification that has already occurred.  Not atherosclerosis an individual might or might not be at risk for based on their cholesterol, but the actual disease in progress.  Why rely solely on surrogates when you can have a picture of the actual state of your arteries?

Data is accumulating that confirms what many doctors already know, even if they’re hesitant to admit it: cholesterol levels often don’t correlate with atherosclerosis.  Data show that “significant ASCVD [atherosclerotic cardiovascular disease] risk heterogeneity exists among those eligible for statins according to the new guidelines. The absence of CAC reclassifies approximately one-half of candidates as not eligible for statin therapy.”  In plain English: half the people who would be put on statins based on cholesterol measurements were not candidates for these potentially dangerous drugs when their actual coronary artery calcification was measured.

Other studies bear similar findings.  According to a study in Korean adults, over 50% of individuals for whom statin therapy was recommended had a CAC score of zero – no calcification.  Based on actual arterial calcification—or, rather, the lack thereof—these individuals were at low risk for cardiovascular events, but without having gotten the CAC test, they might have been treated with statins based solely on the surrogate measurement of LDL.

What about the other side of this?  What about people with normal or even “low” cholesterol?  Does that go hand-in-hand with low risk for a cardiovascular event?

Not quite.  Just as people with high cholesterol might have little to no arterial calcification, people with normal or low cholesterol could have high CAC scores and be at greater risk for heart disease, heart attack, or sudden death.  This exact scenario played out in a study of CAC in low-risk women—low-risk, meaning they had cholesterol in the conventionally “normal” range: “Among women at low ASCVD risk, CAC was present in approximately one-third and was associated with an increased risk of ASCVD and modest improvement in prognostic accuracy compared with traditional risk factors.”  Plain English translation again: one third of women assessed to be at low risk for atherosclerosis already had measurable arterial calcification.  Say it with me for emphasis, folks: the amount of cholesterol in your bloodstream tells you nothing about the amount of atherosclerotic plaque in your arteries.

What is Coronary Artery Calcium and Why Test It?

Unlike your cholesterol, your CAC score gives you visual proof of arterial plaque.  The reason to measure calcium, specifically, is, “Coronary artery calcification is part of the development of atherosclerosis; it occurs exclusively in atherosclerotic arteries and is absent in the normal vessel wall.”  In other words, whether your cholesterol is low, high, or somewhere in the middle, if you have detectable coronary artery calcium, you have atherosclerosis.

And the reason to measure the extent of calcified plaque is that these plaques can rupture, break away from the artery wall, and block the artery, cutting off blood flow to the heart—which is one way heart attacks happen.

If you’re wondering why calcium might end up in your arteries, the main reason is that it’s one of the ways your body repairs damaged blood vessels.  According to Ivor Cummins and Jeffry Gerber, MD, in their book, Eat Rich, Live Long:

“The body’s response to damaged coronary arteries is always the same, and that response is what the CAC scan directly observes and quantifies.  Your body tries to repair itself by depositing calcium in the damaged areas of the arterial wall.  As the damage continues, these repair processes quicken.  They desperately attempt to shore up the arterial walls before a rupture occurs.  This growing calcium becomes the telltale sign of imminent danger—the ultimate canary in the coal mine.”

What is the CAC Test?

The CAC test, also called a “heart scan,” is a non-invasive, special x-ray of the heart and coronary arteries, performed via CT scan (computerized tomography).  The scan itself takes only 20-30 seconds, but the whole procedure, from start to finish, takes about 10-15 minutes.  Fasting is not required, but you may be asked to refrain from smoking or consuming caffeine for four hours before the scan, since an elevated heart rate can reduce the image quality.  Many insurance companies cover this test, but if yours doesn’t, or your doctor won’t order one for you, you can pay for it out of pocket, for about $150 in the U.S.

Test results are usually given as a number called an Agatston score.  This number reflects a composite measurement of the total area of calcium deposits, and the density of the calcium.  According to the Mayo Clinic, a score of zero means no calcium is present, and risk of heart attack is low.  When calcium is present, the higher the score, the higher the risk for heart attack in the long term.  A score of 100 to 300, considered “moderate plaque deposition,” is associated with a high risk of heart disease or heart attack over the next three to five years, and a score over 300 indicates very high to severe risk.

The key thing to know here is, many people (especially low-carbers) have very high cholesterol, but CAC scores of zero.  Even if your score isn’t zero, if it’s very low, that might put your doctor’s fears to rest even if you have high cholesterol.  Keeping the peace with your doctor isn’t a bad reason to have a CAC test, but an even better one is to put your own mind at ease.  

The exact meaning of different coronary calcium scores differ depending on the source cited, but here’s a general guide, according to Axel Sigurdsson, MD:

Coronary calcium score 0: No identifiable plaque. Risk of coronary artery disease very low (<5%)

Coronary calcium score 1-10: Mild identifiable plaque. Risk of coronary artery disease low (<10%)

Coronary calcium score 11-100: Definite, at least mild atherosclerotic plaque. Mild or minimal coronary narrowings likely.

Coronary calcium score 101-400: Definite, at least moderate atherosclerotic plaque. Mild coronary artery disease highly likely. Significant narrowings possible

Coronary calcium score > 400: Extensive atherosclerotic plaque. High likelihood of at least one significant coronary narrowing.

Here’s another look at CAC scores, from Eat Rich, Live Long:

Data adapted from Cardiac CT Imaging: Diagnosis of Cardiovascular Disease


However, a high CAC score doesn’t mean you’re automatically in imminent danger.  If your plaques are stable—that is, they don’t keep increasing over time—your risk for a cardiovascular event remains pretty low.  On the other hand, even if you start out with a relatively low score, if that score increases substantially over time, your risk is much higher.  Remember, as arterial damage worsens, calcium deposition increases, so if your CAC score is going up, your arteries are in worse shape.

From Eat Rich, Live Long:

Track Your Progress

The Heads Up Health app is the perfect place to track your Coronary Artery Calcium scores. See the video below for more information:

Not a Perfect Test

Although a low CAC score generally indicates low risk for cardiovascular events or disease, it’s not a full guarantee.  Unstable coronary plaques vulnerable to rupture may be present in the absence of calcium deposition.  And a high CAC score increases the chances that you have vulnerable plaques, but it doesn’t identify specific places where a rupture or blockage might occur.  Dr. Sigurdsson wrote:

“The presence and extent of coronary calcium are first and foremost markers of the extent of atherosclerosis within the coronary arteries. Nonetheless, it is important to understand that the coronary calcium score does not necessarily reflect the severity of narrowing (the degree of stenosis). Still, a patient with a high calcium score is more likely to have a significant narrowing of a coronary artery than a patient with a low calcium score.  An individual without coronary artery calcification is very unlikely to have a severe narrowing of a coronary artery.  Although cardiovascular events can occur in patients with very low calcium scores, the incidence is very low.”

Take Action

If your CAC score is zero or very low, keep doing what you’re doing!  But if you have a high score, don’t let fear overtake you.  Instead, use that knowledge to spur you to action.  Specifically, consider adopting a

low-carb, higher-fat diet.  Nothing’s more damaging to your blood vessels than chronically high blood sugar or insulin.  Low carb and ketogenic diets have been shown time and again to reduce inflammation, reverse metabolic syndrome, and be beneficial for cardiovascular health.

Not only can you slow the progression of arterial calcification, but you can actually reverse it.  This was virtually unheard of in the past, but that’s because the only things recommended to people with high CAC scores was a low-fat diet and cholesterol-lowering medications.  Since coronary artery calcium has virtually nothing to do with your cholesterol and a lot more to do with repairing damage to blood vessels injured by chronically high glucose and insulin, it’s no wonder a high-carb diet and cholesterol medications made no impact.

On the other hand, a ketogenic or low-carb, high-fat diet might be just the thing to help those blood vessels heal and restore your cardiovascular system to its best functioning.  Use the tracking system here at Heads Up Health to record your CAC score and keep track of all your other health data in one convenient place.

Low-carb Lab Testing — Part 7 — The Kraft Test (Hyperinsulinemia)

Low-carb Lab Testing — Part 7 — The Kraft Test (Hyperinsulinemia)

In many people, high insulin (hyperinsulinemia) is the primary driver of chronic metabolic illness, even when blood glucose is normal. For people concerned with achieving and maintaining optimal health, few things are more important than healthy gluco-regulation—that is, your body’s blood glucose and insulin levels, and how they respond to the foods you eat. Here at Heads Up Health, we’re committed to helping you realize your health goals. Past posts on our blog have explained how to interpret various lab tests for people on low carb diets, such as fasting glucose and hemoglobin A1c. We emphasized that besides just measuring your glucose, it’s imperative to keep track of your insulin levels. Fasting insulin is the most important test most doctors don’t even order.

Another measurement, called HOMA-IR, is the relationship between your fasting glucose and insulin—it tells you how much insulin your body needs in order to keep your blood glucose at a certain level. Because it factors in insulin and not just glucose, HOMA-IR is often a better indicator of metabolic status than glucose alone. But what should you do if your fasting insulin level is normal, but you think you have signs and symptoms of chronic hyperinsulinemia? Is this even possible? Can you have a normal fasting insulin level but have high insulin at other times? Yes! Enter the Kraft test.   

What’s the Kraft Test?

If you’ve never heard of the Kraft test, don’t worry; you’re not alone. It’s not a well-known test in conventional medicine, but it’s gaining popularity among doctors who use low carb and ketogenic diets with their patients. If you’re familiar with the oral glucose tolerance test (OGTT), the Kraft test is a variation on it. In case you don’t know what the OGTT is, let’s start there.

The OGTT is typically used to diagnose type 2 diabetes or gestational diabetes (diabetes during pregnancy). It measures your body’s glucose levels in response to 75 grams of liquid glucose. It’s performed in a lab or a doctor’s office, and it starts off with a baseline or fasting glucose measurement. After that sample is taken, you drink the glucose solution, and then your blood glucose is measured one and two hours later. (Occasionally some labs will include tests at the 30 and 90-minute marks as well.)

Here’s what the American Diabetes Association says about the results.

At the two-hour mark, if your blood glucose is:

  • <140 mg/dL – you are not diabetic
  • 140 – 199mg/dL – you have pre-diabetes
  • ≥200 mg/dL – you have type 2 diabetes

The Kraft test goes beyond the standard OGTT in two ways: 

  1. It measures insulin along with glucose
  2. Instead of only two hours, the test is extended to five hours

With these two small changes, the Kraft test gives you a staggering amount of information you won’t get from the standard OGTT.

Why’s it called the Kraft test? Well, the man who created it was Joseph Kraft, MD. It can also be called an “oral glucose tolerance test with insulin assay,” but in the low carb community, it’s usually referred to as the Kraft test, to honor the man whose work was some of the earliest in uncovering the detrimental effects of chronically high insulin.

By including insulin measurements and extending the test to five hours, what Kraft discovered was nothing short of mind-blowing. As he wrote in his book, Diabetes Epidemic & You, “There are far too many who are told, ‘Don’t worry, your fasting blood sugars are normal.’” And indeed, many people do have normal fasting blood sugar, but that’s only thanks to sky-high insulin. (HOMA-IR can help identify this situation.) And what if your fasting sugar and fasting insulin are both normal, but you suspect your unresolved health issues could be due to high insulin at other times of the day? This is where the Kraft test shines.

To describe the situation of normal glucose with high insulin, Dr. Kraft coined the phrases diabetes in-situ, and occult diabetes—occult meaning “hidden”—the diabetes (that is, the high glucose), is hidden, or masked, by the high insulin. And as we explained in the Heads Up Health post on fasting insulin, even when glucose is normal, chronically high insulin is a major contributor to abdominal obesity, gout, hypertension, PCOS, skin tags, and more. And remember—the official diagnostic criteria for type 2 diabetes are based on glucose measurements alone, not insulin! This is why quite literally millions of people with diabetes in-situ remain undiagnosed, and their medical care team fails to connect hyperinsulinemia to the issues they’re dealing with–because they’re not testing insulin.

The Kraft test shows you your glucose and insulin responses to an oral glucose load. Here’s how it works:

Kraft’s original tests called for 100 grams of glucose solution, but some doctors may use 75 grams. Just as with the standard OGTT, your baseline glucose and insulin levels are recorded via fasting levels. You consume the liquid glucose, and then your glucose and insulin are both measured at the 30-minute mark, and then again at one hour, two, three, four, and five hours.

Kraft identified five distinct patterns of elevated insulin:

Hyperinsulinemia - Kraft Test

Image courtesy of Theodore Naiman, MD


Pattern 1 – Metabolically healthy: In response to a glucose load, the insulin level rises quickly, but moderately, and it comes back down relatively quickly. Fasting insulin and glucose levels are normal, and the peak insulin level is reached at about 30 minutes. By about 3 hours later, it’s back to baseline. Glucose and insulin responses are both normal.

Pattern 2 – Delayed insulin peak: In response to a glucose load, the insulin level rises quickly, but it rises higher than that for the healthy person in pattern 1. Fasting insulin level is normal, and the peak level is reached at 30-60 minutes. In addition to rising higher, insulin takes longer to come back down, not returning to baseline until about 4-5 hours after. Glucose response is normal, but insulin is elevated higher than normal, and it remains elevated for a prolonged amount of time. This pattern indicates hyperinsulinemia.

Pattern 3 – Delayed insulin peak: In response to a glucose load, insulin rises even higher than the already hyperinsulinemic example in pattern 2, but it doesn’t reach its peak until even later. Fasting insulin is normal, but the peak level isn’t reached until the 2 or 3-hour mark. This is a delayed peak, and it takes even longer to come back to baseline. Glucose response may be normal or at diabetic levels; insulin is elevated higher than normal, and it remains elevated for a prolonged amount of time. This pattern indicates hyperinsulinemia.

Pattern 4 – Insulin Resistance: Fasting insulin level is elevated (>10 μU/mL). In response to a glucose load, the already elevated baseline insulin level skyrockets, takes a very long time to come back down, and when it does eventually come down, it comes down only to the baseline, which was already abnormally high. Glucose response is usually at diabetic levels. This pattern is diagnostic for insulin resistance.

Pattern 5 – Insulinopenic (low insulin): Fasting insulin is very low. In response to a glucose load, insulin barely budges, but glucose reaches diabetic levels (possibly as high as ≥300mg/dL). All tested values for insulin over the five hours are <30 μU/mL. When all insulin measurements are low and glucose is elevated, this pattern is suggestive of type 1 diabetes.

To see a more detailed breakdown of the different patterns with both insulin and glucose, check out the guide from Meridian Valley Lab.

A Word of Caution for Low Carbers

Some people who’ve been following a long-term low carb or ketogenic diet will show pattern 5, low insulin. When insulin measurements are low and glucose is also low, this is not considered pathological. (It’s only a problem when glucose is high.) This is known to occur in some long-time low carbers.

BUT: it’s been suggested that people who’ve been following a low carb or ketogenic diet for a while should “carb up” for a week or so to prepare for an OGTT or Kraft test. They should consume about 100-150 grams of carbohydrate for several days in order to get their body re-acclimated to metabolizing a significant amount of carbohydrate. Without this readjustment period, there’s a risk of getting a false result—of appearing to have extremely elevated insulin and/or glucose, when it’s really just that the body isn’t accustomed to dealing with a big wallop of glucose all at once.

Should You Do a Kraft Test?

If you’re satisfied with the results you’re getting from your diet and lifestyle, there isn’t much of a pressing reason to do the Kraft test. (After all, why would you want to drink 75+ grams of liquid glucose, even if you’re not on a low carb diet?) Also, there are other indicators that, taken together, can tip you off as to whether your insulin levels are chronically elevated (such as high triglycerides, low HDL, and a high waist-to-height ratio).

But if you feel like you’ve been doing everything right, yet you’re still dealing with signs & symptoms of a condition that’s known to be driven primarily by high insulin, it might be worth it to see your glucose and insulin in action—especially if your fasting levels for both are normal.

Once you know for sure how your body responds, you can put that data to work for you and let it guide you onto a path to better health. Use the tracking software here at Heads Up Health to do just that. We make it easy to monitor trends in your glucose, ketones, insulin, body measurements, temperature (good for thyroid function), and more, plus you can even track your fasts. Even your Bristol stool score!


Basal Body Temperature Tracking – Part One – Thyroid

Basal Body Temperature Tracking – Part One – Thyroid

Tracking basal body temperature can be a useful tool that can help you to uncover hypothyroid and even hyperthyroid patterns, just by taking your temperature at the same time every morning for five consecutive days.

Heads Up Health makes it easy to track, trend and compare your basal body temperature readings alongside all your other health metrics. Start your free 30-day trial using the button below. Or, read on to learn more about basal body temperature and how to track it.


Basal Body Temperature

Basal Body Temperature TrackingWhen tracking basal body temperature, we want to track your resting temperature which is a reflection of your metabolic activity with minimal influence from outside factors like digestion, exercise, stress, etc.  After you’ve been asleep for several hours, the body has ideally settled into its resting metabolic pattern, so we have a way to compare your temperature with as little interference as possible.

Thyroid Symptoms

Most everyone knows someone with a thyroid condition.  Maybe you even suspect that you have a thyroid condition, but haven’t made an appointment with your doctor yet or your labs have all come back normal.   If you suspect that you may have a thyroid condition, these are some of the symptoms that you may be experiencing.

Hypothyroid Symptoms (more common)

  • low body temperature-feeling cold in a warm room, or having cold hands and feet consistently.
  • apathy or depression
  • lack of motivation
  • fatigue
  • constipation
  • inability to lose weight or weight gain
  • frequent colds
  • swelling in ankles
  • lack of libido
  • hair loss
  • insomnia and more.

Hyperthyroid Symptoms (less common)

  • increased heart rate
  • anxiety
  • insomnia
  • frequent and loose bowel movements
  • sweating
  • unintended weight loss and more.

Hypothyroidism is so prevalent that its become a thing we just expect to have happen to us at some point, and we often accept that these symptoms are just a consequence of getting older.  Symptoms are messengers from our body, alerting us to a system that is out of balance.  The thyroid influences almost every cell in the body, so when it’s not supported, the symptoms can present in other areas of our bodies.  Using the basal body temperature readings developed by Dr. Barnes can help you to hone in on a potential thyroid condition and allow you to seek the help you need to support your thyroid.

Basal Body Temperature Tracking

The basal body temperature test can be used whether or not you’ve had a thyroid test recently.  Thyroid hormones are made in the thyroid, but most of the active (energy) thyroid hormone T3 is converted from the inactive (storage) T4 form in other parts of the body, which means that thyroid function is about more than just the TSH hormone levels in the blood.  Other sites of conversion include the gut (20%), liver (40%) and peripheral tissues (20%). A compromise in the liver or gut can cause a decrease in the conversion of the inactive thyroid hormones to the active thyroid hormones. Another factor to consider is vitamin and mineral deficiencies as the thyroid uses iodine, selenium, zinc, magnesium, the amino acid Tyrosine, as well as vitamins A, C, D, B2, B3, B12 and healthy fats to function optimally.

Because your gut health is a major site of thyroid conversion, Tracking your Bristol Stool Chart can be another piece to the puzzle when trying to figure out a thyroid pattern. Thyroid dysfunction can alter bowel movement patterns as well, which can clue us in to the possibility of a thyroid issue.

The body can compensate for quite a while on reduced resources before the blood will show a significant change to be diagnosed with a thyroid disorder.  Tracking your basal body temperature for 5 days can give you a better understanding of a trend for either hypo or hyper thyroid patterns, so you can further explore paces where the breakdown may be happening.  Hypothyroid is much more common than hyperthyroid, but either can occur. For more info on what labs are important to ask for when you talk to your doc, check out Amy Berger’s article on Thyroid testing here.  Though she talks about it in the context of a low carb diet, the testing info will apply to anyone who thinks they may need a thyroid panel worked up.

HOW to take your Basal Body Temperature for tracking.

Basal Body Temperature Tracking

Prepare the night before you want to start tracking you basal body temperature.  You’ll need a thermometer (glass is preferred as it’s more accurate than digital for this purpose-avoid mercury and opt for a Geratherm glass thermometer which you can find here), your phone/device for timing and documenting your results.

*Note – if you sleep with a heated blanket, or multiple heavy blankets, you’ll want to remove them for the nights that you’ll be collecting your data, to get an accurate reflection of your body temp.

  1. Shake down your thermometer so that it’s ready for morning.  Place all supplies by the bed where you can reach them with minimal effort in the morning.
  2. When you awaken, you will take your thermometer and place it in your armpit for minimum of 5 min (glass will need at least 4 min for accuracy), first thing in the morning.  Try to move minimally so as to not rev up your body temp.  After 5-10 min, record your temperature and go about your day as normal.
  3. Repeat this process for 5 consecutive days.
  4. Ladies, you will want to avoid starting or collecting data on day 19-22 of your menstrual cycle as there are fluctuations due to other hormones as well as related to ovulation, which we will talk about in a subsequent basal temperature tracking article.

Basal Body Temperature Tracking

How to interpret your readings.

Dr. Barnes found that a normal resting body temp should be between 97.8-98.2 degrees Fahrenheit.  If it is consistently lower, then there is a trend toward a hypothyroid (decreased function) pattern.  If consistently above 98.2, then this indicates a trend for more of a hyperthyroid (increased function) presentation.  If results are mixed, both high and low, this is often more indicative of a primary adrenal stress pattern, as the adrenals and thyroid are closely linked, which would allow for the variation in body temperature.

Basal Body Temperature Tracking

What to do with your results

If you find that your temperatures indicate the possibility of thyroid or adrenal stress, take your readings in your Heads Up Health app to your functional health doctor/provider so you can further investigate where the breakdown could be and support for healing.


Disclaimer-  The content in this post is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this post.