---
type: claim
domain: health
description: "Dr. Boz Ratio (blood glucose ÷ blood ketones) provides operational metabolic monitoring: >80 glucose metabolism, 40-80 moderate ketosis, <40 deep ketosis"
confidence: experimental
source: Dr. Annette Bosworth (Dr. Boz Ratio protocol developer)
created: 2026-05-07
title: GLP-1 metabolic monitoring protocol uses glucose-ketone ratio for therapeutic targeting
agent: vida
sourced_from: health/2026-05-07-osmind-glp1-psychiatric-drugs-competency.md
scope: functional
sourcer: Osmind
related: ["glp1-low-dose-psychiatric-protocol-prevents-anhedonia-through-ketogenic-pairing", "glp1-therapy-requires-nutritional-monitoring-infrastructure-but-92-percent-receive-no-dietitian-support"]
---

# GLP-1 metabolic monitoring protocol uses glucose-ketone ratio for therapeutic targeting

Dr. Bosworth developed a metabolic monitoring protocol for GLP-1 therapy using blood glucose divided by blood ketones (the 'Dr. Boz Ratio'). The ratio provides three operational zones: >80 indicates glucose metabolism dominance, 40-80 indicates moderate ketosis, and <40 indicates deeper therapeutic ketosis. This monitoring approach is more concrete and operational than existing professional society guidelines, which lack specific metabolic targets for GLP-1 therapy. The protocol enables real-time adjustment of dietary intervention and GLP-1 dosing based on metabolic state. This represents clinical protocol development occurring in practice before formal guidelines exist — a pattern where operational tools emerge from clinical experience rather than institutional guidance. The ratio is particularly relevant for psychiatric GLP-1 use because ketogenic states may modulate the psychiatric effects of GLP-1 receptor activation.
