Ketone Strips: How They Measure Ketosis

You’re hitting all your macros, working out regularly, and drinking your BHB religiously, but how do you truly know whether you’re in ketosis? Ketone strips are a good way to determine whether your body has transitioned to fat-burning mode. It varies by individual, but in general, it will take 2 to 7 days for your body to achieve ketosis, depending on what you’re eating, your body type, and your activity level.

How do ketone strips work?

When you switch to a low-carb/high-fat diet (75% fat | 20% protein | 5% carbohydrates), your body starts producing molecules called ketones. When you restrict carbohydrate intake while consuming more fat, more ketones are generated. Those ketones are what ketone strips are designed to measure.

The number of ketones you are producing in your blood will give you an idea of the level of ketosis you’ve achieved. In general, higher ketone production helps you achieve or maintain a state of ketosis, which can support weight loss.

Test strips indicate your ketone levels in two ways: blood tests and urine tests. The results are given in millimol per liter (mmol/L) of BHB in the blood or milligram per deciliter (mg/dL) of acetoacetate in urine.

Here’s a breakdown of the ranges:

Blood BHB mmol/L

  • Baseline: <0.5 mmol/L
  • Light Ketosis: 0.5 – 0.8 mmol/L
  • Medium Ketosis: 0.9 – 1.4 mmol/L
  • Deep Ketosis (best for weight loss): 1.5 – 3.0 mmol/L
  • Fasting Ketosis: 3.0 – 8.0 mmol/L

Urine acetoacetate mg/dL

  • Baseline: 0 (negative)
  • Light Ketosis: 5-15 (pink)
  • Medium Ketosis: 40 (mauve)
  • Deep Ketosis (best for weight loss): 160 (dark purple)
  • Fasting Ketosis: >160

What’s the best way to measure my ketones?

These three methods are the most common ways to measure blood ketone levels to determine whether you’re in ketosis.

  • Blood Ketone Meters: The most accurate option, and also the most expensive.
  • Breath Ketone Meters: More accurate than urine strips, but accuracy varies. Less expensive than blood ketone meters.
  • Urine Sticks: The least accurate option, and also the cheapest testing method.

Why are ketone strips important on the keto diet?

Testing ketones can indicate whether or not you need to make adjustments to your diet, or can simply confirm you are on the right track. Many keto dieters find them to be motivating when they see the color indicating a job well done. If the ketone strips don’t show ketosis, it’s a good idea to re-examine your diet to search for hidden carbs which may be keeping you out of ketosis and preventing you from reaching your health goals, such as better managing your diabetes symptoms or losing weight.

How do ketone strips help with weight loss and other health benefits?

Ketone strips don’t directly help you lose weight, but they do let you know whether your blood ketone levels are high enough to achieve a state of ketosis i.e. maximum fat-burning mode. Generally, if your blood glucose levels are high due to a little cheat meal or excess sugar, your ketone levels will be low, serving as a reminder to get back on the wagon.

If being in a state of ketosis helps you better control diabetes, minimizes seizures, improves your metabolic functions, then ketone strips can be an effective tool to help you achieve your health goals.

Are ketone strips required on the keto diet?

Ketone strips are not mandatory on a ketogenic diet, but you may find that having them on hand keeps you motivated and holds you accountable. On the other hand, you may find that testing your ketone levels is an added burden and prefer a more laidback approach. At the end of the day, it is a personal decision and comes down to what works best for helping you achieve your health goals. If you are meeting your goals of weight loss, more stable blood sugar, less insulin dependency, fewer seizures, lower cholesterol, decreased body fat, improved energy and focus, and/or better sleep, then a number on a meter or a color on a test strip is moot.

As you continue your keto journey, keep in mind that consuming keto-friendly whole and unprocessed foods should be your top priority. One key to success is to make sure you’re stocked up on keto essentials for easy meal prep and cooking. Many items on the keto essentials list can be used to make our simple and satiating keto recipes.

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