Ketone levels around 3-4 mmol/L in the context of a ketogenic diet are a normal response to glucose deficiency and fat oxidation, with compensatory mechanisms maintaining pH.

“If you're on a ketogenic diet and your glucose is so low your levels of ketones may approach three or four because of the glucose deficiency that you have in your body. So fat oxidation is so high. It's a very elegant and finely tuned you know response that you have uh with that. So in that context you're presumably in an energetic it's happening slowly enough.”