Glucometer
To track my blood glucose (BG) and my blood ketone levels, I use a meter from Keto-Mojo called the GK+. The meter connects with an app on my phone, and it also saves my readings to app.mymojohealth.com. To use the meter, first insert either a glucose strip or a ketone strip into the meter. When using the meter, you can choose to measure either glucose (xx per strip) or ketones (xx per strip) or both.
I use a lancing device from Accu-Chek (reference here) to prick a finger and then draw a drop of blood into the strip. The Accu-Chek makes it easy to adjust the depth of the lancet (for me the little finger only needs a depth of 4, the middle finger a 5, and all the others a 4.5). One prick is usually good for supplying two drops if you’re measuring both glucose and ketones.
The ketone measurement is needed only when I have a goal of achieving nutritional ketosis. When I first went low-carb, I spent a few months in nutritional ketosis with the goal of adapting my metabolism better to burn fat. I no longer have nutritional ketosis as a goal, and if that’s not your goal, then you don’t need the more expensive ketone strips and may want to consider a glucose-only meter.
My first meter was a Walmart glucose-only meter, and the strips were about the same cost per strip as the Keto-Mojo. These strips, however, came in a bottle of 50 that had to be used within a x-day period after the bottle was opened because air-exposure limits their validity, so they’re intended for high-volume usage. The Keto-Mojo strips are individually wrapped with an expiration date a year out, so they are better suited for intermittent usage. I did notice that the Walmart meter required a much smaller drop of blood.
Levels FreeStyle Libre Continuous Glucose Monitor (CGM)
To understand in more detail the effect on my blood glucose (BG) of various diet and lifestyle changes, I decided to wear a Continuous Glucose Monitor or CGM. I did not qualify to get one through my medical insurance (my A1c was not high enough), so I chose one at my own expense through Levels Health (reference here). It is getting more expensive without insurance than it originally was–they now have an annual subscription cost, and each sensor is about $100 for a 14-day FreeStyle Libre. You can choose how many sensors you want per order to reduce the cost, although you now have to subscribe to two sensors at a time. They also have an option now for the Dexcom sensor. The FreeStyle Libre is about the size of a stack of 3 quarters, and it applies to the back of your upper arm. It communicates via NFC on demand to an app on your smartphone, and it provides a nice line graph of your BG levels over time. I haven’t tried the Dexcom myself. It is a 10-day sensor and provides continues communication to your smartphone or handheld device.
The Levels app allows you to log meals, exercise, and other notes throughout the day, and it also gives you a score from 0 to 100 based on the volatility of your BG. You can then correlate how meals and exercise affect your BG, and you can experiment with different food choices, eating patterns, exercise, etc. to understand which foods and patterns best support you in achieving your goals. The Levels app and website also have lots of great articles to help you understand what you are experiencing, and I have been very pleased with their responsiveness whenever I have reached out for support.
Fitbit
I am on my third Fitbit, a Charge 3. In addition to tracking steps (my goal is 10,000 per day) and floors (goal is 10 per day), I use it for tracking my sleep (goal is weekly average of 7+ hours and 80+ sleep quality score) and resting heart rate (goal is 55 beats per minute). I love that it reminds me every hour to get at least 250 steps since I can sit or stand in front of the computer for more than an hour without noticing (I just got a standing desk which is turning out great). I also love the way the Fitbit app breaks down my sleep into light, deep, and REM (rapid-eye movement) phases. I do notice an effect on my resting heart rate if my sleep is poor or my stress is high, and I will adjust my bedtime and sleep environment to improve my sleep if I notice I’m not meeting my goals for the week. I will also adjust my rest and recovery if I notice my resting heart rate is high, and it will usually respond in a day or two.
Garmin Forerunner 945 with Heart-Rate Monitor (HRM) chest straps and Stryd sensor
My Garmin watch is what drives my exercise and race goals. I got the Forerunner 945 as a parting gift from my company before I “retired”, and it was top of the line at the time for analyzing and advising swimming, biking, and running activities. It can do all the things my Fitbit does, but it’s more bulky and I don’t wear it all the time like I do my Fitbit. It has an algorithm which works very well for me to recommend running work-outs that balance anaerobic, high-aerobic, and low-aerobic (ie. zone 2) exercise. It also estimates my lactate threshold and max V02, which I have used to guide me on training and race strategies. I have two chest straps, Garmin’s TRM or triathlon one for running, biking, and openwater swimming, and Garmin’s swim-only one for the pool (it’s better chlorine-resistant), and I use my heart-rate levels to gauge exertion levels for work-outs and races.
In September I got a Stryd foot pod to more accurately measure distance and speed for treadmill runs, and it also measures my running power in watts. It also advises me on running work-outs and races using power. I ran a 10K race at the end of October, and I was pleased with the training and race results using Stryd. I’m now training for another 10K, perhaps in February.
Elite Heart-Rate Variability (HRV) CorSense
Heart-Rate Variability (HRV) is a metric that I’m finding more useful these days to gauge recovery, and I measure it first thing every morning with the Elite app using their CorSense monitor. CorSense slips on your finger like an SPO2 monitor, and the morning readiness reading takes two minutes. I usually combine it with my morning meditation. HRV indicates the activity levels of your sympathetic (fight or flight) and your parasympathetic (rest and digest) nervous systems. It then uses the two-minutes of measurements to compute a readiness score from 1 to 10, with 1-3 as “red” indicating rest needed, 4-6 as “yellow” indicating caution, and 7-10 as “green” indicating you are ready to handle more load today.
If the app gives you a lower readiness score, it will indicate why. Sometimes it could be because the sympathetic nervous system is over-activated indicating stress levels are high and destressing is indicated. Or, a low readiness score might be because the parasympathetic nervous system is over-activated indicating that the body is in need of recovery and should be allowed to rest. I learned to appreciate the data the score was giving me the other day when it gave me a readiness score of 2. It had detected a high-level of parasympathetic activity and recommended rest. I felt great, so I proceeded to do my planned strength workout that day, and my performance ended up poor (I struggled to keep good form at weight 25% less than I did the previous week). Once I recalled the morning’s low HRV readiness score, I learned to appreciate letting my body recover when my CorSense is telling me parasympathetic activity is elevated.
