Misc Ketones: Dawn affect, ketones during seizures

 July 27, 2025 from Wing, MGH

Nathan 54 pounds

Nathan 7 years old

Nathan gained 5 pounds in 1 month of no seizures! Hooray!

(1) Morning vs. Afternoon Ketones: It’s completely normal for ketone levels to be lower in the morning due to the Dawn Effect. This is our body’s natural release of cortisol in the early morning hours, which increase our blood glucose levels after an overnight fast—consequently, ketones are often lower in the morning than in the afternoon.

(2) Timing Around Seizures: May I ask if the ketone level was taken before or after his seizures? We often see lower ketone levels and higher glucose levels after seizures due to the stress response in the body, which increases the stress hormones and raises the blood glucose. That could also be contributing to the lower ketone level.

Thank you also for sharing his current macros—that’s very helpful. The 5-pound weight gain may also suggest a growth spurt, especially since his weight has been stable for the past 1.5 years. He could be getting taller soon, too! If possible, please keep an eye out for any signs—like needing longer pants or a change in clothing size—as those can be good indicators of growth spurt as well.

We don’t need to make any diet adjustments at this time, but it’ll be important to continue monitoring his overall growth. Let’s plan to check in again in two weeks on his weight.