Measuring the ketones in Urine, using Keto Urine Strips?

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This is done by dipping ketone test strips in the urine, and observing the color changes.  Much like what you might have done in school measuring acids and bases with litmus paper.  You simply observe the color change and compare it with a chart to see what your level is.

Advantages:

◦ They are not affected by alchohol

◦ They are inexpensive

◦ Need to keep buying ketone strips.

Disadvantages

◦ they are not very precise - inaccurate

◦ May not work for everyone

◦ Needs Urine

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Measuring the ketones on our Breath?


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In my opinion, one of the most convenient ways of measuring ketones is using a device called the  "Ketonix".  It actually measures Acetone levels on your breath. (NB results can be skewed by alchohol on your breath, as the sensor doesn't distinguish well between acetone and alcohol)

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Advantages

◦ Accurate (Depending on the model)

◦ Easy to use (Phone app with the Ketonix)

◦ Only need to breathe into it.


Disadvantages

◦ Expensive (US$79-US$179 as of Nov 2020) (But coming down in price)


◦ Sensitive to Alcohol (Can skew the readings)

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NB. Our noses can also smell acetone on the breath, and many people in ketosis complain of bad breath (Also know known as "Keto Breath"). 

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Measuring ketones in the blood?

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Measuring blood ketone levels requires the use of a ketone blood meter is considered the most accurate, although it will depend on the device as usual.  One of the recommended ones is "Keto-Mojo" which will give a good standard reading.


Advantages

◦ Accurate when Keto Levels are High

◦ Readings not skewed by alcohol


Disadvantages

◦ Expensive (for an accurate one)

◦ Need to prick your finger to draw blood for every test.

◦ Need to buy special strips, which usually cost around US$1


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Which method is Best?

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That really depends.  If cost is your main consideration then you will probably have to use the urine strips, simply because they are the cheapest.

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If your after something non-invasive, convenient and with decent accuracy , then I would go with the breathalizer.  But be careful to do your research, as they can be of varying accuracy, the Ketonix is a reputable brand that is worth checking out.

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The Blood meter can be the most accurate, but requires a finger prick and can get expensive,  but like all these machines, the accuracy and cost can vary.  So do your research and find out which one will be the best for you.

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What about Exogenous Ketones?

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Many people take exogenous ketones and are under the false impression they are in ketosis.  In fact much of the marketing hype about such drinks is geared around the idea that you can get shortcut your way into ketosis by drinking ketones (or rather ketone salts).



This is very misleading.

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I previously mentioned that being in Ketosis is where your body is using fat and creating ketones.  Drinking ketones (ketone salts) does nothing to help your liver process fat.  All it does is put ketones in your blood. 

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Drinking Ketones and saying your in ketosis becasue you can measure them in your blood is like pushing a car and saying the engine is working because you can see the car moving.

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The ultimate result is that you have too many ketones in your body, many of which are not used, and need to be excreted.  It's a great way to make very expensive urine, but by no means puts you in ketosis.

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There is some research going on regarding ketone esthers, which may be worth looking at in the future, but for now it's mostly just hype.

What is Ketosis?

What is Ketosis?Ketosis is where your body is burning fat as a fuel.   This means that your visceral body fat is being converted into Ketones by the liver, providing a new fuel source for the body.  (This requires restricting the carbohydrate intake, as your body will take care of carbs first, either by burning them as fuel or storing them as fat with insulin. Insulin takes the excess sugars in your blood and converts them to fat, storing them up for a rainy day.)These Ketones then become the fuel source for the body and brain.  In fact Ketones cross the blood-brain barrier and become a fuel source for the Central Nervous system, as an alternative to glucose (sugar).

How do I get into Ketosis?

Ketosis is a natural metabolic state, in other words, it is just one of the natural ways your body processes food into energy.  By default your body uses carbs as fuel, and as this is pretty much the modern diet, we have no problem getting carbs. (Sugar is also under the umbrella of carbs).

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The trouble is when whe have too many carbs, they increase glucose in the blood.  If our body can't use all the glucose and burn it as energy then it needs to get it out of the blood, and it does this by using insulin.  Insulin essentially helps our body to convert these carbs to fat which is stored for a rainy day.  A rainy day that never comes because the modern diet just keeps pumping in the carbs, and rarely do we draw on those deposited fat reserves..

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If we keep getting carbs our body has no reason to switch to use something else.. reducing the carbs forces the body to use another energy source.

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It's next choice is fat.. and so long as we have enough fat  it won't go and burn protein, ie. muscles.  (In fact the body adapts to preserve muscle tissue, so unless we are fasting for long periods of time without food, and have no fat reserves we are generally good to go) 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1373635/


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So simply speaking to get our body into ketosis, we need to restrict our carbs enough so that our body switches to burn fat, and keep up with that restricted diet, as long as we choose to. (This is the time when people typically experience things like the Keto Flu, and need to stay extra hydrated)


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To burn fat your body sends it to the liver which  processes it and produces ketones.  These Ketones cannot be used by the liver, but can be used by our brain and muscles instead of glucose for fuel.  (When Ketones are produced by the liver these are known as Endogenous Ketones.) 

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So as we go into ketosis we will see an increase in ketone production, and an increase in Ketones in our blood which can be measured.  As ketones get excreted in our urine and breath, we can also measure the level of ketones there too. 

To know whether we are in ketosis we can therefore measure the level of ketones in our Urine, Breath, or Blood.

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Basically you take a measurement before you start your keto diet, then keep measuring your ketones until you see them increase.  Once they increase and stay there, you know you are in ketosis.  (N.B.  See the below about exogenous ketones to find out more)

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Each test measures a different ketone, present during fat metabolism: Beta-hydroxybutyrate, acetoacetate or acetone, and because of this the results are not directly comparable, but neverthless give an indication of Ketosis.

Which method of measuring ketones is best?

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Lets look briefly at each method: 

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As each device measures ketones in a different way it's not possible to directly compare the readings, but they do give an indication of ketosis.

To learn more about Exogenous Ketones check our article here: What are Exogenous Ketones?

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